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Objective: The study aim was to investigate associations of 11 anthropometric measures with incident type 2 diabetes and compare their predictive performance. Methods: This prospective cohort study included 161,127 White European UK Biobank participants who were free of diabetes at baseline. Anthropometric measures included height, weight, BMI, A Body Shape Index, waist circumference, waist to hip ratio, waist to height ratio (WHtR), hip circumference, visceral adiposity index, hip index, and anthropometric risk index. The associations were examined using Cox proportional hazard models. The differences in C‐index were used to compare predictive performance between BMI and other anthropometric measures. Results: The median follow‐up was 10.0 (interquartile range: 9.3–10.8) years, during which 6315 participants developed type 2 diabetes. All markers except height and hip index were positively associated with incident type 2 diabetes. The strongest associations were found for WHtR (hazard ratio per 1‐SD increment: 2.27 [95% CI 2.19–2.35] in women; 1.96 [95% CI 1.90–2.01] in men). Compared with BMI, WHtR and anthropometric risk index had significantly better type 2 diabetes risk discrimination. Conclusions: Although most adiposity markers were associated with type 2 diabetes, the magnitude of the associations differed. WHtR had the strongest associations and predictive ability for type 2 diabetes and thus could be a more suitable marker for clinical use. [ABSTRACT FROM AUTHOR]

Aims: To investigate the combined association of adiposity and walking pace with incident type 2 diabetes. Methods: We undertook a prospective cohort study in 194 304 White‐European participants (mean age 56.5 years, 55.9% women). Participants' walking pace was self‐reported as brisk, average or slow. Adiposity measures included body mass index (BMI), waist circumference (WC) and body fat percentage (BF%). Associations were investigated using Cox proportional hazard models, with a 2‐year landmark analysis. A four‐way decomposition analysis was used for mediation and additive interaction. Results: The median (interquartile range) follow‐up was 5.4 (4.8‐6.3) years. During the follow‐up period, 4564 participants developed type 2 diabetes. Compared to brisk‐walking participants with normal BMI, those with obesity who walked briskly were at an approximately 10‐ to 12‐fold higher risk of type 2 diabetes (hazard ratio [HR] 9.64, 95% confidence interval [CI] 7.24‐12.84, in women; HR 11.91, 95% CI 8.80‐16.12, in men), whereas those with obesity and walked slowly had an approximately 12‐ to 15‐fold higher risk (HR 12.68, 95% CI 9.62‐16.71, in women; HR 15.41, 95% CI 11.27‐21.06, in men). There was evidence of an additive interaction between WC and BF% and walking pace among women, explaining 17.8% and 47.9% excess risk respectively. Obesity mediated the association in women and men, accounting for 60.1% and 44.9%, respectively. Conclusions: Slow walking pace is a risk factor for type 2 diabetes independent of adiposity. Promoting brisk walking as well as weight management might be an effective type 2 diabetes prevention strategy given their synergistic effects. [ABSTRACT FROM AUTHOR]