Relative fat mass (RFM) had the highest hazard ratio for type 2 diabetes mellitus risk in both women (HR per SD = 2.42) and men (HR per SD = 2.22), and abdominal adiposity indices outperformed general adiposity indices such as BMI in predicting T2DM risk.
Key Findings
Results
Relative fat mass (RFM) had the highest hazard ratio for T2DM risk among 17 anthropometric indices in both women and men.
In women, HR per SD for RFM = 2.42 (95% CI: 2.34–2.49)
In men, HR per SD for RFM = 2.22 (95% CI: 2.13–2.31)
17 anthropometric indices were systematically examined across both cohorts
Cox regression models were used to estimate hazard ratios
Results
Abdominal adiposity indices outperformed general adiposity indices in predicting T2DM risk.
Abdominal adiposity indices examined included waist circumference (WC), waist-to-height ratio (WHtR), and body roundness index (BRI)
General adiposity indices such as BMI showed lower predictive performance compared to abdominal adiposity indices
Predictive performance was assessed using receiver operating characteristic (ROC) curves
Methods
The study included large prospective cohort samples with long follow-up periods from the Shanghai Men's and Women's Health Studies.
71,356 women were included with a mean follow-up of 17.42 years
56,288 men were included with a mean follow-up of 12.35 years
Data were drawn from two prospective cohort studies conducted in China
Results
Sex-specific differences were observed in the associations between abdominal adiposity indices and T2DM risk.
Notable sex-specific differences were identified in the predictive value of abdominal adiposity indices
RFM was identified as a better predictor in both women and men, though with different magnitude of effect (HR 2.42 vs. 2.22 per SD)
Subgroup and sensitivity analyses were conducted to evaluate robustness of findings
Methods
The study systematically compared 17 anthropometric indices for their association with and prediction of T2DM risk.
Indices included both general adiposity measures (e.g., BMI) and abdominal adiposity measures (e.g., WC, WHtR, BRI, RFM)
Cox regression models estimated hazard ratios for each index
ROC curves were used to assess predictive performance of each index
Zhou X, Li Z, Yang D, Shen Q, Zhou Y, Tan Y, et al.. (2026). Comparison and assessment of anthropometric index with risk of type 2 diabetes mellitus: two prospective cohort studies in China.. Diabetes research and clinical practice. https://doi.org/10.1016/j.diabres.2026.113121