Link between body fat percentage and the future risk of diabetes in Chinese individuals with prediabetes: A 5-year longitudinal cohort study

Objective: Given the scarce research on the link between body fat percentage(BF%) and diabetes risk among Chinese adults with prediabetes, our study aimed to investigate the relationship between BF% and the likelihood of developing diabetes in this group. Methods: This historical cohort study included 26,014 Chinese individuals diagnosed with prediabetes, who underwent health evaluations between 2010 and 2016.We utilized Cox proportional hazards regression models to investigate the relationship between baseline BF% and the risk of diabetes in adults diagnosed with prediabetes. Furthermore, we utilized Cox proportional hazards models in combination with cubic spline functions and smooth curve fitting to assess the nonlinear relationship between initial BF% and the onset of diabetes. To ensure the dependability of our findings, we conducted various sensitivity and subgroup analyses. Results: After controlling for various covariates, the research indicated a positive correlation between BF% and diabetes risk (HR=1.43, 95% CI: 1.31-1.55, p<0.0001).The likelihood of developing diabetes progressively rose across the BF% quartiles (Q1 to Q4), with Q4 showing a significantly elevated risk relative to Q1 (adjusted HR=1.96, 95% CI=1.63-2.36).Furthermore, a nonlinear association emerged between BF% and diabetes risk in adults with prediabetes, marked by an inflection point at 25.2%.On the left side of this turning point, the HR stood at 3.14 (95% CI 2.08-4.75), whereas on the right side, it was 1.28 (95% CI 1.16-1.42). Conclusion: Our study indicates a positive, nonlinear relationship between BF% and diabetes risk among Chinese individuals with prediabetes. For this population, reducing BF% can lower the risk of developing diabetes, particularly when BF% is decreased to below 25.2%.