Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study

Background The prognostic value of anthropometric, adipokine, and computed tomography measures of adiposity to predict diabetes in Black, specifically by normoglycemia versus prediabetes, remains incompletely understood. Methods and Results Among Black participants without diabetes in the JHS (Jacks...

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Autores principales:	Joshua J. Joseph, Bjorn Kluwe, Justin B. Echouffo‐Tcheugui, Songzhu Zhao, Guy Brock, David Kline, James B. Odei, Rita R. Kalyani, David P. Bradley, Willa A. Hsueh, Mario Sims, Sherita H. Golden
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	adiposity Black adults diabetes health equity visceral adipose tissue waist circumference Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/361e82dc99314656bf329e3654d9b759
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spelling	oai:doaj.org-article:361e82dc99314656bf329e3654d9b7592021-11-23T11:36:35ZAssociation of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study10.1161/JAHA.120.0207162047-9980https://doaj.org/article/361e82dc99314656bf329e3654d9b7592021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.020716https://doaj.org/toc/2047-9980Background The prognostic value of anthropometric, adipokine, and computed tomography measures of adiposity to predict diabetes in Black, specifically by normoglycemia versus prediabetes, remains incompletely understood. Methods and Results Among Black participants without diabetes in the JHS (Jackson Heart Study), waist circumference [WC], body mass index, adiponectin, leptin, and leptin:adiponectin ratio were standardized in sample 1 (2422 participants at baseline [2000–2004]) and WC, body mass index, visceral adipose tissue (VAT), subcutaneous adipose tissue, and liver attenuation in 1537 participants at examination 2 (2005–2008) (sample 2). Hazard ratios (HRs) for diabetes were estimated using interval‐censored Cox modeling adjusting for traditional risk factors and validated with the C index. Over 5 years, 300 and 122 incident diabetes cases occurred in sample 1 and sample 2, respectively. In sample 1 and sample 2, a 1‐SD higher log‐leptin:adiponectin ratio and VAT had the strongest associations (HR, 1.95 [95% CI, 1.67–2.27] and 1.76 [95% CI, 1.52–2.04]) and discriminatory power (C index 0.68 [95% CI, 0.64–0.71] and C index 0.67 [95% CI, 0.61–0.74]) with diabetes. The normoglycemic compared with the prediabetes group had a 1.3 to 1.9 times greater magnitude of associations with diabetes for WC, liver attenuation, and VAT (P interaction <0.10). In sample 2, C indices for WC (HR, 0.84; 95% CI, 0.73–0.95), VAT (HR, 0.91; 95% CI, 0.85–0.98), and liver attenuation (HR, 0.90; 95% CI, 0.77–1.00) were greater than HbA1c (HR, 0.74; 95% CI, 0.57–0.90) in normoglycemia, whereas HbA1c was best in prediabetes (HR, 0.72; 95% CI, 0.66–0.78). Conclusions Overall, among Black adults, multiple measures of adiposity were associated with incident diabetes with modest predictive ability. In Black patients with normoglycemia, WC, liver attenuation, and VAT may appropriately identify those at high risk for diabetes, whereas HbA1c was the best predictor in individuals with prediabetes.Joshua J. JosephBjorn KluweJustin B. Echouffo‐TcheuguiSongzhu ZhaoGuy BrockDavid KlineJames B. OdeiRita R. KalyaniDavid P. BradleyWilla A. HsuehMario SimsSherita H. GoldenWileyarticleadiposityBlack adultsdiabeteshealth equityvisceral adipose tissuewaist circumferenceDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adiposity Black adults diabetes health equity visceral adipose tissue waist circumference Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	adiposity Black adults diabetes health equity visceral adipose tissue waist circumference Diseases of the circulatory (Cardiovascular) system RC666-701 Joshua J. Joseph Bjorn Kluwe Justin B. Echouffo‐Tcheugui Songzhu Zhao Guy Brock David Kline James B. Odei Rita R. Kalyani David P. Bradley Willa A. Hsueh Mario Sims Sherita H. Golden Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study
description	Background The prognostic value of anthropometric, adipokine, and computed tomography measures of adiposity to predict diabetes in Black, specifically by normoglycemia versus prediabetes, remains incompletely understood. Methods and Results Among Black participants without diabetes in the JHS (Jackson Heart Study), waist circumference [WC], body mass index, adiponectin, leptin, and leptin:adiponectin ratio were standardized in sample 1 (2422 participants at baseline [2000–2004]) and WC, body mass index, visceral adipose tissue (VAT), subcutaneous adipose tissue, and liver attenuation in 1537 participants at examination 2 (2005–2008) (sample 2). Hazard ratios (HRs) for diabetes were estimated using interval‐censored Cox modeling adjusting for traditional risk factors and validated with the C index. Over 5 years, 300 and 122 incident diabetes cases occurred in sample 1 and sample 2, respectively. In sample 1 and sample 2, a 1‐SD higher log‐leptin:adiponectin ratio and VAT had the strongest associations (HR, 1.95 [95% CI, 1.67–2.27] and 1.76 [95% CI, 1.52–2.04]) and discriminatory power (C index 0.68 [95% CI, 0.64–0.71] and C index 0.67 [95% CI, 0.61–0.74]) with diabetes. The normoglycemic compared with the prediabetes group had a 1.3 to 1.9 times greater magnitude of associations with diabetes for WC, liver attenuation, and VAT (P interaction <0.10). In sample 2, C indices for WC (HR, 0.84; 95% CI, 0.73–0.95), VAT (HR, 0.91; 95% CI, 0.85–0.98), and liver attenuation (HR, 0.90; 95% CI, 0.77–1.00) were greater than HbA1c (HR, 0.74; 95% CI, 0.57–0.90) in normoglycemia, whereas HbA1c was best in prediabetes (HR, 0.72; 95% CI, 0.66–0.78). Conclusions Overall, among Black adults, multiple measures of adiposity were associated with incident diabetes with modest predictive ability. In Black patients with normoglycemia, WC, liver attenuation, and VAT may appropriately identify those at high risk for diabetes, whereas HbA1c was the best predictor in individuals with prediabetes.
format	article
author	Joshua J. Joseph Bjorn Kluwe Justin B. Echouffo‐Tcheugui Songzhu Zhao Guy Brock David Kline James B. Odei Rita R. Kalyani David P. Bradley Willa A. Hsueh Mario Sims Sherita H. Golden
author_facet	Joshua J. Joseph Bjorn Kluwe Justin B. Echouffo‐Tcheugui Songzhu Zhao Guy Brock David Kline James B. Odei Rita R. Kalyani David P. Bradley Willa A. Hsueh Mario Sims Sherita H. Golden
author_sort	Joshua J. Joseph
title	Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study
title_short	Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study
title_full	Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study
title_fullStr	Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study
title_full_unstemmed	Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study
title_sort	association of adiposity with incident diabetes among black adults in the jackson heart study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/361e82dc99314656bf329e3654d9b759
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Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study

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