***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Type 2 diabetes is a common manifestation of hemochromatosis , a disease of iron overload . However , it is not clear whether higher iron stores predict the development of type 2 diabetes in a healthy population . OBJECTIVE To examine plasma ferritin concentration and the ratio of the concentrations of transferrin receptors to ferritin in relation to risk of type 2 diabetes . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve nested case-control study within the Nurses ' Health Study cohort . Of the 32 826 women who provided blood sample s during 1989 - 1990 and were free of diagnosed diabetes , cardiovascular disease , and cancer , 698 developed diabetes during 10 years of follow-up . The controls ( n = 716 ) were matched to cases on age , race , and fasting status ; and on body mass index ( BMI ) for cases in the top BMI decile . MAIN OUTCOME MEASURE Incident cases of type 2 diabetes . RESULTS Among cases , the mean ( SD ) concentration of ferritin was significantly higher ( 109 [ 105 ] vs 71.5 [ 68.7 ] ng/mL for controls ; P<.001 for difference ) and the mean ( SD ) ratio of transferrin receptors to ferritin was significantly lower ( 102 [ 205 ] vs 141 [ 340 ] , respectively ; P = .01 ) . In conditional logistic regression stratified on the matching factors and controlled for BMI and other diabetes risk factors , the multivariate relative risks [ RRs ] of incident type 2 diabetes across increasing quintiles of ferritin were 1.00 , 1.09 ( 95 % confidence interval [ CI ] , 0.70 - 1.70 ) , 1.26 ( 95 % CI , 0.82 - 1.95 ) , 1.30 ( 95 % CI , 0.83 - 2.04 ) , and 2.68 ( 95 % CI , 1.75 - 4.11 ) ( P<.001 for trend ) . The RRs across increasing quintiles of transferrin receptors to ferritin ratio were 2.44 ( 95 % CI , 1.61 - 3.71 ) , 1.00 ( 95 % CI , 0.64 - 1.56 ) , 1.13 ( 95 % CI , 0.73 - 1.74 ) , 0.99 ( 95 % CI , 0.64 - 1.53 ) , and 1.00 ( P = .01 for trend ) . Further adjustment for an inflammatory marker ( C-reactive protein ) did not change the results appreciably . The associations persisted within strata defined by levels of BMI , menopausal status , alcohol consumption , and C-reactive protein . CONCLUSION Higher iron stores ( reflected by an elevated ferritin concentration and a lower ratio of transferrin receptors to ferritin ) are associated with an increased risk of type 2 diabetes in healthy women independent of known diabetes risk factors Diabetes mellitus is associated with tuberculosis . A cohort of 42,116 clients aged 65 years or more , enrolled at 18 Elderly Health Service centers in Hong Kong in 2000 , were followed up prospect ively through the territory-wide tuberculosis registry for development of tuberculosis from 3 months after enrollment to December 31 , 2005 , by use of their identity card numbers as unique identifier . The effects of diabetes mellitus and diabetic control on tuberculosis risk were assessed with adjustment for sociodemographic and other background variables . Diabetes mellitus was associated with a modest increase in the risk of active , culture-confirmed , and pulmonary ( with or without extrapulmonary involvement ) but not extrapulmonary ( with or without pulmonary involvement ) tuberculosis , with adjusted hazard ratios of 1.77 ( 95 % confidence interval : 1.41 , 2.24 ) , 1.91 ( 95 % confidence interval : 1.45 , 2.52 ) , 1.89 ( 95 % confidence interval : 1.48 , 2.42 ) , and 1.00 ( 95 % confidence interval : 0.54 , 1.86 ) , respectively . Diabetic subjects with hemoglobin A1c < 7 % at enrollment were not at increased risk . Among diabetic subjects , higher risks of active , culture-confirmed , and pulmonary but not extrapulmonary tuberculosis were observed with baseline hemoglobin A1c > or = 7 % ( vs. < 7 % ) , with adjusted hazard ratios of 3.11 ( 95 % confidence interval : 1.63 , 5.92 ) , 3.08 ( 95 % confidence interval : 1.44 , 6.57 ) , 3.63 ( 95 % confidence interval : 1.79 , 7.33 ) , and 0.77 ( 95 % confidence interval : 0.18 , 3.35 ) , respectively CONTEXT Diabetes is a serious and costly disease that is becoming increasingly common in many countries . The role of diabetes as a cancer risk factor remains unclear . OBJECTIVE To examine the relationship between fasting serum glucose and diabetes and risk of all cancers and specific cancers in men and women in Korea . DESIGN , SETTING , AND PARTICIPANTS Ten-year prospect i ve cohort study of 1,298,385 Koreans ( 829,770 men and 468,615 women ) aged 30 to 95 years who received health insurance from the National Health Insurance Corp and had a biennial medical evaluation in 1992 - 1995 ( with follow-up for up to 10 years ) . MAIN OUTCOME MEASURES Death from cancer and registry-documented incident cancer or hospital admission for cancer . RESULTS During the 10 years of follow-up , there were 20,566 cancer deaths in men and 5907 cancer deaths in women . Using Cox proportional hazards models and controlling for smoking and alcohol use , the stratum with the highest fasting serum glucose ( > or = 140 mg/dL [ > or = 7.8 mmol/L ] ) had higher death rates from all cancers combined ( hazard ratio [ HR ] , 1.29 ; 95 % confidence interval [ CI ] , 1.22 - 1.37 in men and HR , 1.23 ; 95 % CI , 1.09 - 1.39 in women ) compared with the stratum with the lowest level ( < 90 mg/dL [ < 5.0 mmol/L ] ) . By cancer site , the association was strongest for pancreatic cancer , comparing the highest and lowest strata in men ( HR , 1.91 ; 95 % CI , 1.52 - 2.41 ) and in women ( HR , 2.05 ; 95 % CI , 1.43 - 2.93 ) . Significant associations were also found for cancers of the esophagus , liver , and colon/rectum in men and of the liver and cervix in women , and there were significant trends with glucose level for cancers of the esophagus , colon/rectum , liver , pancreas , and bile duct in men and of the liver and pancreas in women . Of the 26,473 total cancer deaths in men and women , 848 were estimated as attributable to having a fasting serum glucose level of less than 90 mg/dL. For cancer incidence , the general patterns reflected those found for mortality . For persons with a diagnosis of diabetes or a fasting serum glucose level greater than 125 mg/dL ( 6.9 mmol/L ) , risks for cancer incidence and mortality were generally elevated compared with those without diabetes . CONCLUSION In Korea , elevated fasting serum glucose levels and a diagnosis of diabetes are independent risk factors for several major cancers , and the risk tends to increase with an increased level of fasting serum glucose Background — Abdominal adiposity is a growing clinical and public health problem . It is not known whether it is similarly associated with cardiovascular disease ( CVD ) and diabetes mellitus in different regions around the world , and thus whether measurement of  waist circumference ( WC ) in addition to body mass index ( BMI ) is useful in primary care practice . Methods and Results — R and omly chosen primary care physicians in 63 countries recruited consecutive patients aged 18 to 80 years on 2 prespecified half days .  WC and BMI  were measured and the presence of CVD and diabetes mellitus recorded . Of the patients who consulted the primary care physicians , 97 % agreed to participate in the present study . Overall , 24 % of 69 409 men and 27 % of 98 750 women were obese ( BMI ≥30 kg/m2 ) . A further 40 % and 30 % of men and women , respectively , were overweight ( BMI 25 to 30 kg/m2 ) . Increased WC ( > 102 for men and > 88 cm for women ) was recorded in 29 % and 48 % , CVD in 16 % and 13 % , and diabetes mellitus in 13 % and 11 % of men and women , respectively . A statistically significant grade d increase existed in the frequency of CVD and diabetes mellitus with both BMI and WC , with a stronger relationship for WC than for BMI across regions for both genders . This relationship between WC , CVD , and particularly diabetes mellitus was seen even in lean patients ( BMI < 25 kg/m2 ) . Conclusions — Among men and women who consulted primary care physicians  , BMI and particularly WC were both strongly linked to CVD and especially to diabetes mellitus . Strategies to address this global problem are required to prevent an epidemic of these major causes of morbidity and mortality BACKGROUND Increased abdominal adiposity has been linked to an increase in mortality in population s where many are overweight or obese ; it is unclear whether the same is true in relatively lean population s. METHODS We examined the association between waist-hip ratio and mortality in the Shanghai Women 's Health Study , a population -based , prospect i ve cohort study of Chinese women aged 40 to 70 years enrolled from December 28 , 1996 , through May 23 , 2000 , 95 % of whom had a body mass index ( calculated as weight in kilograms divided by height in meters squared ) of less than 30.0 . Included in this analysis were 72 773 nonsmoking women who had anthropometrics taken by trained interviewers at enrollment and who were followed up through December 31 , 2004 . Deaths were ascertained by biennial home visits and linkage with the vital statistics registry . RESULTS During a mean follow-up of 5.7 years , 1456 deaths occurred . The waist-hip ratio was positively and significantly associated with deaths from all causes , cardiovascular disease , and diabetes ( P<.01 for trend ) . A less significant positive association was found for death from cancer . After adjustment for body mass index and other potential confounders , the relative risks of total mortality were 1 ( reference group ) , 1.28 ( 95 % confidence interval [ CI ] , 1.04 - 1.58 ) , 1.40 ( 95 % CI , 1.14 - 1.72 ) , 1.54 ( 95 % CI , 1.26 - 1.88 ) , and 1.95 ( 95 % CI , 1.60 - 2.38 ) across the lowest to the highest waist-hip ratio quintiles . The positive association appeared to be more evident in women with a lower body mass index . The relative risks of total mortality comparing the extreme waist-hip ratio quintiles were 2.36 ( 95 % CI , 1.71 - 3.27 ) , 1.60 ( 95 % CI , 1.10 - 2.34 ) , and 1.46 ( 95 % CI , 0.97 - 2.20 ) for women with a body mass index of less than 22.3 , 22.3 to 25.1 , and 25.2 or greater , respectively . CONCLUSION Abdominal adiposity independently predicts mortality risk , particularly for nonobese women Prevention of type 2 diabetes by intensive lifestyle intervention design ed to achieve and maintain ideal body weight was assessed in subjects with impaired glucose tolerance ( IGT ) . Male subjects with IGT recruited from health-screening examinees were r and omly assigned in a 4:1 ratio to a st and ard intervention group ( control group ) and intensive intervention group ( intervention group ) . The final numbers of subjects were 356 and 102 , respectively . The subjects in the control group and in the intervention group were advised to maintain body mass index ( BMI ) of < 24.0 kg/m2 and of < 22.0 kg/m2 , respectively , by diet and exercise . In the intervention group , detailed instructions on lifestyle were repeated every 3 - 4 months during hospital visits . Diabetes was judged to have developed when two or more consecutive fasting plasma glucose ( FPG ) values exceeded 140 mg/dl . A 100 g oral glucose tolerance test was performed every 6 months to detect improvement of glucose tolerance . The subjects were 
    Output:
    
Type 2 diabetes is an increasing epidemic in Asia , characterized by rapid rates of increase over short periods and onset at a relatively young age and low body mass index .