Population attributable risk for diabetes associated with excess weight in Tehranian adults: a population-based cohort study

BACKGROUND Little evidence exists regarding the magnitude of contribution of excess weight to diabetes in the Middle East countries. This study aimed at quantification of the impact of overweight and obesity on the incidence of type 2 diabetes mellitus (T2DM) at a population level in Tehran, Iran. METHODS Using data of a population-based short-term cohort study in Iran, which began in 1997 with 3.6-year follow-up, we calculated the adjusted odds ratios (OR) and population attributable risks (PAR) of developing T2DM, i.e. the proportion of diabetes that could have been avoided had overweight and/or obesity not been present in the population. RESULTS Of the 4728 subjects studied, aged > or = 20 years, during the 3.6-year follow-up period, 3.8% (n = 182) developed T2DM. This proportion was 1.4%, 3.6%, and 7.8% for the normal, overweight, and obese subjects, respectively. When compared to normal BMI, the adjusted ORs for incident diabetes were 1.76 [95% confidence interval (CI) 1.07 to 2.89] for overweight and 3.54 (95% CI 2.16 to 5.79) for obesity. The PARs adjusted for family history of diabetes, age, triglycerides, systolic blood pressure was 23.3% for overweight and 37.1% for obesity. These figures were 7.8% and 26.6% for men and 35.3% and 48.3% for women, respectively. CONCLUSION Incident T2DM is mainly attributable to excess weight, significantly more so in Tehranian women than men. Nonetheless, the contribution of excess weight in developing T2DM was lower in our short-term study than that reported in long-term periods. This probably reflects the significant role of other risk factors of T2DM in a short-term follow-up. Hence, prevention of excess weight probably should be considered as a major strategy for reducing incidence of T2DM; the contribution of other risk factors in developing T2DM in short-term period deserve to be studied and be taken into account.