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Title: A fit-fat index for predicting incident diabetes in apparently healthy men: A prospective cohort study
Authors: Sloan R.A.
Haaland B.A. 
Sawada S.S.
Lee I.-M.
Sui X.
Lee D.-C.
Ridouane Y.
Müller-Riemenschneider F. 
Blair S.N.
Keywords: adult
body fat
body mass
cardiorespiratory fitness
cohort analysis
diabetes mellitus
diagnostic test accuracy study
fit fat index
major clinical study
prospective study
random forest
receiver operating characteristic
risk assessment
waist to height ratio
area under the curve
diabetes mellitus
follow up
middle aged
proportional hazards model
risk factor
Area Under Curve
Cardiorespiratory Fitness
Diabetes Mellitus
Follow-Up Studies
Middle Aged
Proportional Hazards Models
Prospective Studies
Risk Factors
Waist-Height Ratio
Issue Date: 2016
Publisher: Public Library of Science
Citation: Sloan R.A., Haaland B.A., Sawada S.S., Lee I.-M., Sui X., Lee D.-C., Ridouane Y., Müller-Riemenschneider F., Blair S.N. (2016). A fit-fat index for predicting incident diabetes in apparently healthy men: A prospective cohort study. PLoS ONE 11 (6) : e0157703. ScholarBank@NUS Repository.
Abstract: Background: The purpose of this study was to examine the impact of combined cardiorespiratory fitness and waist-to-height ratio in the form of a fit-fat index on incident diabetes risk. Additionally, the independent predictive performance of cardiorespiratory fitness, waist-to-height ratio, and body mass index also were estimated and compared. Methods: This was a prospective cohort study of 10,381 men who had a normal electrocardiogram and no history of major chronic disease at baseline from 1979 to 2005. Random survival forest models and traditional Cox proportional hazards models were used to predict diabetes at 5-, 10-, and 15-year incidence horizons. Results: Overall, 4.8% of the participants developed diabetes. Receiver operating characteristic curve analyses for incidence risk demonstrated good discrimination using random survival forest models across fitness and fatness measures; Cox models were poor to fair. The differences between fitness and fatness measures across horizons were clinically negligible. Smoothed random survival forest estimates demonstrated the impact of each fitness and fatness measure on incident diabetes was intuitive and graded. Conclusions: Although fitness and fatness measures showed a similar discriminative ability in predicting incident diabetes, unique to the study was the ability of the fit-fat index to demonstrate a better indication of incident risk when compared to fitness or fatness alone. A single index combining cardiorespiratory fitness and waist-to-height ratio may be more useful because it can indicate improvements in either or both of the measures. © 2016 Sloan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
ISSN: 19326203
DOI: 10.1371/journal.pone.0157703
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