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Life sciences · Journal article
Asia-pacific Journal of Convergent Research Interchange · September 28, 2026
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The association between waist circumference (WC)-defined abdominal obesity and diabetes is well documented, but recent nationally representative Korean studies that account for sociodemographic, behavioral, metabolic, family-history, and medication-related factors remain limited.We analyzed 4,235 adults aged ≥19 years from the 2023 Korea National Health and Nutrition Examination Survey.Diabetes was defined by fasting plasma glucose, glycated hemoglobin, physician diagnosis, or current glucose-lowering treatment, and abdominal obesity was defined using sex-specific WC cutpoints (≥90 cm in men and ≥85 cm in women).Four sequential complexsample logistic regression models were used to incorporate sociodemographic, behavioral, metabolic/clinical progressively, and family history/medication-use covariates to estimate adjusted associations.The population-weighted prevalence of diabetes was 9.9%.In the fully adjusted model, normal WC was associated with lower odds of diabetes than abdominal obesity (OR=0.45,95% CI: 0.36-0.57).No family history of diabetes was also associated with lower odds (OR=0.42,95% CI: 0.32-0.54).After adding family history and medication-use covariates, the previously observed association between normal LDL cholesterol and diabetes was attenuated and no longer statistically significant.Nagelkerke R² increased from 0.152 in the base model to 0.221 in the fully adjusted model.A sensitivity analysis excluding influential observations identified by Cook's distance produced a similar estimate for normal WC (OR=0.46,95% CI: 0.36-0.57).The WC-by-sex interaction was not significant (p_interaction=0.264),whereas the WC-by-age-group interaction was significant (p_interaction<0.001).WC-defined abdominal obesity remained associated with diabetes after adjustment for the measured covariates.These cross-sectional findings do not establish causality or demonstrate improved screening performance.Prospective studies are needed to evaluate the potential role of WC in diabetes risk assessment.