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Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the epic-interact case-cohort study
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نویسنده
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langenberg c. ,sharp s.j. ,schulze m.b. ,rolandsson o. ,overvad k. ,forouhi n.g. ,spranger j. ,drogan d. ,huerta j.m. ,arriola l. ,de lauzon-guillan b. ,tormo m.-j. ,ardanaz e. ,balkau b. ,beulens j.w.j. ,boeing h. ,bueno-de-mesquita b. ,clavel-chapelon f. ,crowe f.l. ,franks p.w. ,gonzalez c.a. ,grioni s. ,halkjaer j. ,hallmans g. ,kaaks r. ,kerrison n.d. ,key t.j. ,khaw k.t. ,mattiello a. ,nilsson p. ,norat t. ,palla l. ,palli d. ,panico s. ,quirós j.r. ,romaguera d. ,romieu i. ,sacerdote c. ,sánchez m.j. ,slimani n. ,sluijs i. ,spijkerman a.m.w. ,teucher b. ,tjonnel a. ,tumino r. ,van der a.d.l. ,van der schouw y.t. ,feskens e.j.m. ,riboli e. ,wareham n.j.
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منبع
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plos medicine - 2012 - دوره : 9 - شماره : 6 - صفحه:17
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چکیده
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Background: waist circumference (wc) is a simple and reliable measure of fat distribution that may add to the prediction of type 2 diabetes (t2d),but previous studies have been too small to reliably quantify the relative and absolute risk of future diabetes by wc at different levels of body mass index (bmi). methods and findings: the prospective interact case-cohort study was conducted in 26 centres in eight european countries and consists of 12,403 incident t2d cases and a stratified subcohort of 16,154 individuals from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. we used prentice-weighted cox regression and random effects meta-analysis methods to estimate hazard ratios for t2d. kaplan-meier estimates of the cumulative incidence of t2d were calculated. bmi and wc were each independently associated with t2d,with wc being a stronger risk factor in women than in men. risk increased across groups defined by bmi and wc; compared to low normal weight individuals (bmi 18.5-22.4 kg/m 2) with a low wc (<94/80 cm in men/women),the hazard ratio of t2d was 22.0 (95% confidence interval 14.3; 33.8) in men and 31.8 (25.2; 40.2) in women with grade 2 obesity (bmi≥35 kg/m 2) and a high wc (>102/88 cm). among the large group of overweight individuals,wc measurement was highly informative and facilitated the identification of a subgroup of overweight people with high wc whose 10-y t2d cumulative incidence (men,70 per 1,000 person-years; women,44 per 1,000 person-years) was comparable to that of the obese group (50-103 per 1,000 person-years in men and 28-74 per 1,000 person-years in women). conclusions: wc is independently and strongly associated with t2d,particularly in women,and should be more widely measured for risk stratification. if targeted measurement is necessary for reasons of resource scarcity,measuring wc in overweight individuals may be an effective strategy,since it identifies a high-risk subgroup of individuals who could benefit from individualised preventive action. please see later in the article for the editors' summary. © 2012 langenberg et al.
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آدرس
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mrc epidemiology unit,institute of metabolic science,addenbrooke's hospital,box 285,cambridge cb2 0qq, United Kingdom, mrc epidemiology unit,institute of metabolic science,addenbrooke's hospital,box 285,cambridge cb2 0qq, United Kingdom, department of molecular epidemiology,german institute of human nutrition potsdam rehbruecke,arthur-scheunert-allee 114-116,14558 nuthetal, Germany, department of public health and clinical medicine,umeå university,norrlands universitetsjukhus,90185 umeå, Sweden, department of epidemiology,school of public health,bartholins allé 2,dk-8000 aarhus c, Denmark, mrc epidemiology unit,institute of metabolic science,addenbrooke's hospital,box 285,cambridge cb2 0qq, United Kingdom, charité-universitätsmedizin berlin,department of endocrinology,diabetes and nutrition,chariteplatz 1,10117 berlin, Germany, department of epidemiology,german institute of human nutrition potsdam-rehbruecke,arthur- scheunert-allee 114-116,14558 nuthetal, Germany, department of epidemiology,murcia regional health council,ronda de levante 11,30008 murcia,spain,consortium for biomedical research in epidemiology and public health,ciber epidemiología y salud pública,melchor fernández almagro 3-5,28029 madrid, Spain, consortium for biomedical research in epidemiology and public health,ciber epidemiología y salud pública,melchor fernández almagro 3-5,28029 madrid,spain,public health division of gipuzkoa,basque government,av. navarra 4,20013 san sebastian,spain,instituto bio-donostia,hospital donostia,20014 donostia, Spain, inserm,cesp centre for research in epidemiology and population health,u1018: epidemiology of diabetes,obesity and chronic kidney disease over the lifecourse,16 av paul vaillant couturier,94807 villejuif cedex,france,university paris sud 11,umrs 1018,94807 villejuif cedex, France, department of epidemiology,murcia regional health council,ronda de levante 11,30008 murcia,spain,consortium for biomedical research in epidemiology and public health,ciber epidemiología y salud pública,melchor fernández almagro 3-5,28029 madrid, Spain, consortium for biomedical research in epidemiology and public health,ciber epidemiología y salud pública,melchor fernández almagro 3-5,28029 madrid,spain,navarre public health institute,leyre 15,31003 pamplona,navarra, Spain, inserm,cesp centre for research in epidemiology and population health,u1018: epidemiology of diabetes,obesity and chronic kidney disease over the lifecourse,16 av paul vaillant couturier,94807 villejuif cedex,france,university paris sud 11,umrs 1018,94807 villejuif cedex, France, julius center for health sciences and primary care,university medical center utrecht,stratenum 6.131,po box 85.500,3508 ga utrecht, Netherlands, department of epidemiology,german institute of human nutrition potsdam-rehbruecke,arthur- scheunert-allee 114-116,14558 nuthetal, Germany, national institute for public health and the environment (rivm),po box 1,3720 ba bilthoven,netherlands,department of gastroenterology and hepatology,university medical centre,utrecht, Netherlands, inserm,cesp centre for research in epidemiology and population health,u1018: nutrition,hormones and women's health,igr,39 rue camilles desmouolins,94800 villejuif cedex, France, cancer epidemiology unit,nuffield department of clinical medicine,university of oxford,richard doll building,roosevelt drive,oxford ox3 7lf, United Kingdom, department of public health and clinical medicine,umeå university,norrlands universitetsjukhus,90185 umeå,sweden,department of clinical sciences,clinical research center,skåne university hospital,lund university,20502 malmö, Sweden, unit nutrition,environment and cancer,department of epidemiology,catalan institute of oncology,gran via s/n km 2,7,l'hospitalet de llobregat,08907 barcelona, Spain, fondazione irccs istituto nazionale tumori milan,via venezian 1,20133 milan, Italy, danish cancer society research center,strandboulevarden 49,2100 copenhagen, Denmark, department of public health and clinical medicine,umeå university,norrlands universitetsjukhus,90185 umeå, Sweden, german cancer research centre,im neuenheimer feld 280,69120 heidelberg, Germany, mrc epidemiology unit,institute of metabolic science,addenbrooke's hospital,box 285,cambridge cb2 0qq, United Kingdom, cancer epidemiology unit,nuffield department of clinical medicine,university of oxford,richard doll building,roosevelt drive,oxford ox3 7lf, United Kingdom, department of public health and primary care,university of cambridge addenbrooke's hospital,box 251,cambridge cb2 2qq, United Kingdom, department of clinical and experimental medicine federico ii university,via pansini,5-80131 naples, Italy, university of lund,department of clinical sciences medicine,university hospital scania,205 02 malmo, Sweden, department of epidemiology and biostatistics,school of public health,imperial college london,st mary's campus,norfolk place,london w2 1pg, United Kingdom, mrc epidemiology unit,institute of metabolic science,addenbrooke's hospital,box 285,cambridge cb2 0qq, United Kingdom, molecular and nutritional epidemiology unit,ispo ponte nuovo,via delle oblate 4,50141 florence, Italy, university of lund,department of clinical sciences medicine,university hospital scania,205 02 malmo, Sweden, public health directorate,9 ciriaco miguel vigil st,33006 oviedo, Spain, department of epidemiology and biostatistics,school of public health,imperial college london,st mary's campus,norfolk place,london w2 1pg, United Kingdom, international agency for research on cancer,150 cours albert thomas,69372 lyon cedex 08, France, center for cancer prevention (cpo-piemonte),via santena 7,10126 torino,italy,human genetics foundation (hugef),via nizza 52,10126 torino, Italy, consortium for biomedical research in epidemiology and public health,ciber epidemiología y salud pública,melchor fernández almagro 3-5,28029 madrid,spain,andalusian school of public health,cuesta del observatorio 4,ap. correos 2070,18080 granada, Spain, international agency for research on cancer,150 cours albert thomas,69372 lyon cedex 08, France, julius center for health sciences and primary care,university medical center utrecht,stratenum 6.131,po box 85.500,3508 ga utrecht, Netherlands, national institute for public health and the environment (rivm),po box 1,3720 ba bilthoven, Netherlands, german cancer research centre,im neuenheimer feld 280,69120 heidelberg, Germany, danish cancer society research center,strandboulevarden 49,2100 copenhagen, Denmark, cancer registry and histopathology unit,civile - m.p. arezzo hospital,asp 7 via dante nr. 109,97100 ragusa, Italy, national institute for public health and the environment (rivm),po box 1,3720 ba bilthoven, Netherlands, julius center for health sciences and primary care,university medical center utrecht,stratenum 6.131,po box 85.500,3508 ga utrecht, Netherlands, division of human nutrition - section nutrition and epidemiology,university of wageningen,po box 8129,6700 ev wageningen, Netherlands, department of epidemiology and biostatistics,school of public health,imperial college london,st mary's campus,norfolk place,london w2 1pg, United Kingdom, mrc epidemiology unit,institute of metabolic science,addenbrooke's hospital,box 285,cambridge cb2 0qq, United Kingdom
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