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  • Participants were drawn from the Atherosclerosis Risk in Communities (ARIC) study, a large, ongoing, prospective cohort study designed to investigate the etiology of atherosclerosis and disease outcomes of adults residing in four U.S. communities: Baltimore, Maryland; Minneapolis, Minnesota; Jackson, Mississippi; and Winston-Salem, North Carolina. Approximately 4,000 individuals aged 45–64 years old were enrolled at each ARIC site between 1987 and 1989 [11,12]. All participants signed an informed consent document. Baseline de-identified ARIC data from 14,812 participants with and without T2DM were obtained from BioLINCC (https://biolincc.nhlbi.nih.gov/home/) [13]. The current secondary data analysis was approved by the Augusta University (formerly Medical College of Georgia) Institutional Review Board. T2DM was the outcome variable, defined according to the American Diabetes Association criteria [14] by one or more the following: fasting blood glucose ≥ 126mg/dL, non-fasting blood glucose ≥ 200 mg/dL, self-reported diabetes diagnosis, or taking diabetes medications. Diabetes status and anthropometric data were collected with each study visit. The following seven anthropometric measures were included in our analysis: a body shape index [ABSI = waist circumference (cm) / (BMI0.66 x height (m)0.5)], body adiposity index [BAI = hip circumference (cm) / ((height (m)1.5) -18)], body mass index [BMI = body weight (kg) / height (m2)], waist circumference [WC, cm], waist to hip ratio [WHR = waist circumference (cm) / hip circumference (cm)], waist to height ratio [WHtR = waist circumference (cm) / height (cm)], and waist to hip to height ratio [WHHR = WC (cm) / (hip circumference (cm)/ height (cm))]. These variables were calculated from body weight, height, WC, and hip circumference measured in the fasted state, in light clothing without shoes, by trained ARIC technicians. WC was measured using an anthropometric tape at the level of the umbilicus with the participant standing [15]. Hip circumference was measured at the maximal protrusion of the buttocks. Race identification and gender were self-reported. Age (continuous) was the only variable considered for covariate adjustment. We tested the inclusion of variables for cigarette smoking (current, former, never (yes/no)) and alcohol intake (g/day) in the models. However, these variables did not appreciably decrease the Akaike Information Criteria (AIC) of their respective models, and therefore were excluded from the final analysis. Physical activity using the sports domain of the Baecke questionnaire responses [16] collected at visits one and three only, and highest education level completed (
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