The aim of this study was to investigate the effet of physical activity on the association between adiposity and type 2 diabetes as well as the association between adiposity and physical activity according to glucose status in middle-aged and older Chinese population. The study cohort included 28,946 subjects (aged ≥50 years, 72.4% women) from the Guangzhou Biobank Cohort Study. Analyses revealed that the waist-to-hip ratio (WHR) showed the strongest association with diabetes compared to waist circumference and body mass index. It was also found that moderate-to-vigorous activity was negatively associated with diabetes, but not walking. In contrast to adiposity measures, there was no significant association of physical activity with impaired fasting glucose. Even though both WHR and physical activity were independently associated with type 2 diabetes, the association of WHR with diabetes was stronger than that of physical activity. In fact, within the low WHR tertile, moderate-to-vigorous activity was not associated with diabetes. However, within the high WHR tertile, the most active group had an odds ratio (OR) of 2.94 (95% CI: 2.41-3.59), whereas the inactive group had an OR of 3.87 (95% CI: 3.22-4.65). Thus, these results confirm the strong association between abdominal adiposity and type 2 diabetes and suggest that physical activity must be a factor to target in primary prevention for type 2 diabetes.
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