What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 Diabetes Mellitus (n=4007). Intervention: Waist circumference (WC) ≥ 90 cm vs. Waist circumference (WC) < 90 cm. Primary outcome: Type 2 Diabetes Mellitus (T2DM) in males aged 18-59 (OR 3.211, 95% CI 1.625-6.346, p=<0.001).

June 7, 2021Open Access

Comparison of Different Obesity Indices associated with Type 2 Diabetes Mellitus among Different Sex and Age Groups in China

Q: What are the key findings of this study?

Waist circumference was the best predictor of type 2 diabetes in males (OR 3.211 for ages 18-59), whereas waist-to-height ratio and BMI were the best predictors for females aged 18-59 and ≥60.

QGQiwei GeNantong University MLMin LiAnhui University ZXZhengcheng XuNantong University

Key Result

Waist circumference was the best predictor of type 2 diabetes in males (OR 3.211 for ages 18-59), whereas waist-to-height ratio and BMI were the best predictors for females aged 18-59 and ≥60.

Study Design

Type

Cross-Sectional (n=4,007)

Multicenter

Structured PICO

Population

4,007 adult community-dwelling residents in China, aged 18 and older, evaluated for the association between various anthropometric obesity indices and type 2 diabetes mellitus.

Outcome

Association of five anthropometric indices (BMI, BAI, WC, WHR, and WHtR) with Type 2 diabetes mellitus (T2DM)

Waist circumference is the best anthropometric predictor of Type 2 Diabetes Mellitus in Chinese men, whereas waist-to-height ratio and BMI are better predictors in women aged 18-59 and ≥60 years, respectively.

Main Result

Odds Ratio: 3.211 (95% CI 1.625–6.346)

p-value: p=<0.001

Limitations

Cross-sectional study design prevents proving causality between obesity indices and T2DM.
Participants with known T2DM may have altered their lifestyle habits, potentially skewing anthropometric indices.
Participants were recruited from a single area, limiting extrapolation to other regions with different diets and lifestyles.

Abstract

Abstract Background: Obesity is associated with type 2 diabetes mellitus (T2DM), but the obesity index most closely related to type 2 diabetes is still controversial. Therefore, the aim of this study was to compare the associations of five anthropometric indices (body mass index (BMI), body adiposity index (BAI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)) with Type 2 diabetes mellitus (T2DM) among Chinese adults divided into four groups according to sex and age. Methods: A total of 4,007 adult participants (1,669 males and 2,338 females) were included. Odds ratios (OR) and 95% confidence intervals were used with binary logistic regression models to estimate the risk of T2DM for each obesity index. Furthermore, we compared the area under the ROC curve (AUC) of each obesity index for the criterion of hypertension under the influence of risk factors. Results: For the males, WC had the highest value of OR (3.211 and 1.452) and AUC (0.783 and 0.614) in both age groups. However, WHtR (OR=2.366, AUC=0.771) and BMI (OR=1.596, AUC=0.647) tended to be the best criteria for T2DM among females in the 18-59 and ≥60 years age groups, respectively. Conclusions: This study suggests that there is a positive association of obesity-related anthropometric indices with T2DM in different sex and age groups. For males, WC appears to be the best anthropometric index for predicting T2DM. For 18-59 and ≥60 age women, the best obesity indices related with T2DM are WHtR and BMI, respectively.

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