Cardiovascular disease (CVD) has been a leading cause of death in China
. Diabetes and prediabetes are the major risk factors for the cardiovascular disease, and the prevalence of diabetes and prediabetes in Chinese adults has been elevated to 9.7% and 15.5%, respectively
. Although the prevalence of diabetes and prediabetes in China remains lower than that in the industrialized countries, the enormous population in China, estimated to be over 1.3 billion, makes the largest population with diabetes in the world. A national survey conducted in 2007–2008, involving 46,239 Chinese adults showed that there were 92.4 million Chinese suffering from diabetes (50.2 million men and 42.2 million women), with an additional 148.2 million living with prediabetes (76.1 million men and 72.1 million women)
The American Diabetes Association (ADA) refers to patients with impaired fasting glucose (IFG) as having “pre-diabetes”, which indicates the relatively high risk for development of diabetes in these patients
. With the high prevalence of IFG, the prevalence of diabetes could continue to increase rapidly in China. Recently, International Diabetes Federation (IDF) has estimated the number of people worldwide with diabetes for 2011 and 2030 and shows that the global diabetes epidemic continues to grow
. By 2030, the number of individuals with diabetes worldwide is expected up to 552 million and most people with diabetes live in low-and middle-income countries where the diabetes drugs and insulin are often inaccessible or too expensive, and the local health-care systems do not have the capacity deal with personnel and financial issues.
As diabetes is becoming a serious threat to human being’s health, using a simple and inexpensive screening method for early diagnosis is particularly important
[5, 6]. The Third Report of the National Cholesterol Education Program Expert Panel (NCEP ATP III) suggested that abdominal obesity is an independent risk factor for diabetes and measuring waist circumference (WC) is an effective tool to screen individuals at high-risk of diabetes
[7, 8]. However, because WC cannot fully discriminate intra-abdominal from subcutaneous abdominal adiposity, the elevated triglyceride levels have been adopted as a marker of “dysfunctional” adipose tissue, intra-abdominal obesity and associated metabolic abnormalities in people with an increased waistline
[9–11]. Therefore, the concept of hypertriglycedemic-waist (HTGW) phenotype has been used as a simple and inexpensive screening approach to identify people at increased risk of cardiovascular disease
[12–14]. Lemieux et al.
 were the first group to recognize that the HTGW phenotype was associated with increased CVD risk in men. In particular, the HTGW was associated with the atherogenic triad of hyperinsulinemia, elevated concentrations of apolipoprotein B and small, dense low density lipoprotein-cholesterol (sdLDL-C) particles. In corroboration, HTGW is associated with increased CVD risk in women
. After 7.5 years of follow-up in a low-risk middle-aged men population, HTGW was associated with the risk of CVD
Although abdominal obesity and hypertriglyceridemia have been known as risk factors for diabetes, limited data are available in the linkage of HTGW phenotype to prediabetes and diabetes. Currently, only one study has shown that the phenotype of abdominal obesity HTGW was highly prevalent in Chinese adults, 35.4% in the women, 33.6% in the men, and the phenotype of visceral obesity HTGW was closely associated with prediabetes and diabetes
. However, it is a cross-sectional study in which it is difficult to derive HTGW from etiology of prediabetes and diabetes. Therefore, we conducted a cohort study to evaluate whether HTGW, as the phenotype of visceral obesity, was closely associated with the risk of prediabetes and diabetes among Chinese urban adults.