Predictive value of a body shape index for incident type 2 diabetes and all-cause mortality in adults: Evidence from two long-term cohort studies
Authors' conclusion
ABSI is a simple and reliable predictor of T2DM onset and mortality. Routine assessment of ABSI during annual health check-ups may facilitate early identification of individuals at high risk for T2DM and adverse outcomes.
Study context
- Population
- Adults in a Japanese cohort (13-year follow-up) and the U.S. NHANES 1999–2019 T2D cohort
- Exposure
- Higher vs lower A Body Shape Index
- Outcome
- Incident T2D and subsequent all-cause mortality
Methodological detailstwo long-term cohorts (Japanese cohort, 13-year follow-up; U.S. NHANES 1999-2019 T2D cohort), participants stratified by median A Body Shape Index (ABSI), multivariable Cox proportional hazards models, restricted cubic spline and mediation analyses
- Two long-term cohorts (Japanese cohort, 13-year follow-up; U.S. NHANES 1999-2019 T2D cohort)
- Participants stratified by median ABSI
- Multivariable Cox proportional hazards models
- Restricted cubic spline and mediation analyses
Main finding
As reported in the abstract
13-year T2D incidence; 20-year all-cause mortality
Estimate (95 % CI)
Higher ABSIvs Lower ABSI
HR (13-year T2D incidence) 2.14(1.73–2.65)
Higher ABSIvs Lower ABSI
HR (20-year all-cause mortality) 1.95(1.30–2.93)
Observational data: associations, not effects.
Further findings
Body mass index (BMI) association with outcomes
- BMI exhibited nonlinear associations with T2D incidence and mortality
Mediation of ABSI–T2D association
%
- Proportion mediated by fatty liver
- 14.06
- Proportion mediated by blood lipids
- 8.12
- Proportion mediated by blood pressure
- 14.59
- Most of the association remained directly associated with ABSI
- May partially mediate
Original publication
Predictive value of a body shape index for incident type 2 diabetes and all-cause mortality in adults: Evidence from two long-term cohort studies. Diabetes Res Clin Pract. Published 30 November 2025. doi:10.
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