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Purpose: We sought to determine the association of hip circumference with risk of type 2 diabetes in a relatively lean population. Methods: The relationship between hip circumference for a given waist circumference or BMI and risk of type 2 diabetes was investigated in 56,100 men and 68,273 women, aged 40 to 74, from the Shanghai Men’s Health Study and the Shanghai Women’s Health Study. Cox analyses were used. Results: Over an average of 4.0 years and 7.8 years of follow-up of the men and women, respectively, 2754 new diabetes cases (955 males; 1799 females) were documented. After adjustment for body mass index (BMI), waist circumference, and other potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in quintiles 2 to 5 compared with the first quintile of hip circumference were 0.95 (95% CI, 0.76–1.18), 0.72 (95% CI, 0.57–0.91), 0.83 (95% CI, 0.67–1.04), 0.78 (95% CI, 0.63–0.97), respectively, among men and 0.83 (95% CI, 0.72–0.96), 0.74 (95% CI, 0.64–0.86), 0.72 (95% CI, 0.62–0.84), and 0.65 (95% CI, 0.56–0.75) among women. This relationship was stronger for men and women with a BMI less than or equal to the median (23.6 kg/m2 for each gender; interaction p-value = .04 for men and .01 for women). Conclusions: A greater hip circumference for a given waist circumference and BMI is associated with a reduced risk of type 2 diabetes. [ABSTRACT FROM AUTHOR]