Joseph JJ, Kluwe B, Echouffo‐Tcheugui JB, et al. - Associations of multiple measures of adiposity with incident diabetes were found in Black adults, with evident modest predictive ability of such measures. Black patients with normoglycemia who were at high risk for diabetes may be appropriately identified by waist circumference [WC], liver attenuation, and visceral adipose tissue (VAT), whereas hemoglobin A _1c was revealed as the best predictor in those with prediabetes.

• Black participants without diabetes in the JHS (Jackson Heart Study) were analyzed.

• Sample 1 comprised 2422 participants at baseline (2000–2004) and sample 2 included 1537 participants at examination 2 (2005–2008).

• In both samples, a 1‐SD higher log‐leptin:adiponectin ratio and VAT showed the strongest links (hazard ratios, 1.95 and 1.76) and discriminatory power (C index 0.68 and C index 0.67) with diabetes.

• A 1.3 to 1.9 times greater magnitude of links with diabetes for WC, liver attenuation, and VAT were present in the normoglycemic vs the prediabetes group.