Background Inflammation has been suggested a possible mechanism linking adiposity with type 2 diabetes. Central obesity indicated by waist circumference (WC) measurement is thought to be a greater risk factor for chronic low-grade inflammation compared to general obesity characterised by body mass index (BMI). However, evidence for this association is still equivocal. In this study we compare biomarker relationships with BMI and WC measures and type 2 diabetes. We examine a range of pro-inflammatory cytokines, acute-phase response proteins, coagulation factors, white blood cell counts and a combination of these markers to determine which measurement is more strongly associated with diabetes-related inflammation.

Methods This was a cross-sectional study involving a random sample of 2,002 men and women aged 50–69 years. Correlation and logistic regression analyses were used to explore general and central obesity measurement relationships with non-optimal biomarker levels, biomarker combinations and type 2 diabetes.

Results When compared to BMI, WC was more strongly related to a majority of inflammatory markers, adverse biomarker clustering and type 2 diabetes. In multivariable analysis, only WC remained significantly associated with type 2 diabetes (OR: 2.96, 95% CI: 1.93–4.55) after adjusting for BMI (OR: 0.73, 95% CI: 0.49–1.10) four or more markers (OR: 4.67, 95% CI: 2.64–8.27) and other potential confounders.

Conclusion These data suggest that central obesity is a greater risk factor for chronic inflammation and type 2 diabetes than BMI. However, our results also indicate that relationships between markers of inflammation and diabetes cannot be completely explained by surrogate measures of adiposity.