Background: Obesity can lead to the development of type 2 diabetes mellitus (T2DM). However, the predictive power of different obesity anthropometric indices (ObAIs) for T2DM varies with race and geographical area. Therefore, the study aimed to investigate the association between different ObAIs and T2DM and determine the best index for screening T2DM in middle-aged and elderly men and women in Beijing, China.
Methods: A cross-sectional study was conducted in Shijingshan district (Beijing, China) from November 2011 to August 2012, involving a total of 14,558 subjects aged ≥ 40 years. Data on demographic information, lifestyle, history of T2DM, hypertension and dyslipidemia were collected. Body height, body weight, waist circumference (WC), hip circumference, and blood pressure were recorded. The oral glucose tolerance test or a standard meal test and blood lipid test were performed. The relationship between different ObAIs and T2DM was analyzed using multiple logistic regression.
Results: After adjustment for age, smoking status, alcohol intake, occupation and education degree, diabetes family history, hypertension and dyslipidemia, body mass index (BMI), WC, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were positively associated with T2DM in both men and women. Compared with the lowest BMI, WC, WHR, and WHtR quartiles, ORs of the highest quartiles were 2.131 (95% CI: 1.465– 3.099), 1.752 (95% CI: 1.270– 2.417), 1.342 (95% CI: 1.072– 1.678), 2.739 (95% CI: 2.293– 3.271) in men and 1.837 (95% CI: 1.584– 2.130), 3.122 (95% CI: 1.980– 4.924), 3.781 (95% CI: 2.855– 5.007), 2.379 (85% CI: 2.040– 2.775), respectively, in women. The areas under ROC curve of BMI, WC, WHR, and WHtR for men were 0.584 (95% CI: 0.568– 0.600), 0.509 (95% CI: 0.492– 0.525), 0.501 (95% CI: 0.485– 0.518), and 0.642 (95% CI: 0.627– 0.658) and 0.619 (95% CI: 0.607– 0.632), 0.709 (95% CI: 0.697– 0.720), 0.741 (95% CI: 0.730– 0.752), and 0.654 (95% CI: 0.642– 0.666), respectively, for women.
Conclusion: WHtR and WHR have been found to perform better as predictors of T2DM in middle-aged and elderly Chinese men and women, respectively.
Keywords: obesity, anthropometric indices, type 2 diabetes mellitus, middle-aged and elderly, Chinese