Comparison of anthropometric indices (body mass index,waist circumference,waist to hip ratio and waist to height ratio) in predicting risk of type II diabetes in the population of Yazd,Iran

Background and objectives

The purpose of this study was to determine the best anthropometric index and calculate the cut-off point for each anthropometric index in predicting the risk of type II diabetes in the population of Yazd city in Iran.

Comparison of abdominal obesity measures in predicting of 10-year cardiovascular risk in an Iranian adult population using ACC/AHA risk model: A population based cross sectional study

Background

Several abdominal obesity measures have been used for prediction of 10-year cardiovascular disease (CVD) risk but the superiority of these measures remains controversial. The objective of this study was to assess the predictive ability of abdominal obesity measures for risk of CVD events in an Iranian adult population.

Design and validation of a novel estimator of visceral adipose tissue area and comparison to existing adiposity surrogates

Aims

Visceral adiposity measured by computed tomography (CT) as intra-abdominal fat area (IAFA) predicts metabolic diseases. Existing adiposity surrogates have not been systematically compared to a regression-based model derived in individuals of Japanese ancestry. We developed and validated a method to estimate IAFA in individuals of Japanese ancestry and compared it to existing adiposity surrogates.

Waist circumference, body mass index and waist to hip ratio for prediction of the metabolic syndrome in Chinese

Background and aimsTo explore the ability of waist circumference (WC), body mass index (BMI) and waist to hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (MetS) among individuals aged 18–85 in North China.Methods and resultsThis study is a cluster sample survey of 101,510 individuals, complete data are 75,788 subjects, 59,874 males and 15,914 females. Their ages were 51.9 ± 12.7 years (males) and 48.7 ± 11.5 years (females). Receiver operating characteristic (ROC) analysis was used to examine discrimination and find optimal cut off values of WC, BMI and WHR to predict two or more non-adipose components of MetS. The area under the ROC curve (AURC) for WC (0.694) and BMI (0.692) in females showed no difference. In males BMI (0.657) had a better discrimination than WC (0.634). WHR was weaker in both sexes. The optimal cut off value of WC in males (86.5 cm) was higher than in females (82.1 cm); and that of BMI was about 24 kg/m² in both genders. The optimal cut off values of WC, BMI, and WHR, increased with age in both sexes.ConclusionsBMI and WC are more useful than WHR for predicting two or more non-adipose components of MetS. Cut off values for WC in males, and those of BMI and WHR in both sexes are lower than that in present MetS criteria; WC in females is slightly higher. Cut off values of WC, BMI and WHR were increased with age in the Chinese.     

Gender-specific associations of body mass index and waist circumference with type 2 diabetes mellitus in Chinese rural adults: The Henan Rural Cohort Study

Aim

To assess the relationship between various obesity categories according to body mass index (BMI) and waist circumference (WC) and risk of type 2 diabetes mellitus (T2DM) among Chinese rural adults.

腰围、腰高比、内脏脂肪指数对大连地区40岁以上新诊断糖尿病前期女性患者的预测价值

目的探讨WC、腰高比(WHtR)、内脏脂肪指数(VAI)对大连地区40岁以上新诊断糖尿病前期女性患者的预测价值。方法依托REACTION研究,选取2725名受试者,随访3年后最终纳入2044名受试者。分析WC、WHtR及VAI预测糖尿病前期发生的价值及合适的切点。结果2044名受试者3年后共有317例(15.51%)出现糖尿病前期。二元Logistic回归分析结果显示,WC、WHtR及VAI均是糖尿病前期患病的危险因素(OR 1.023、2.013、1.259,95%CI 1.004~1.042、1.580~2.564、1.124~1.410,P<0.05或P<0.01)。分别以WC、WHtR、VAI为检验变量,绘制预测糖尿病前期的受试者工作特征曲线,结果显示,WC、WHtR及VAI预测糖尿病前期的曲线下面积分别为0.598,0.602及0.625,合适切点分别为82.5 cm、0.55及1.45。经Z检验证实,VAI的预测效果优于WC及WHtR(Z=3.352、2.930,P<0.05)。结论WC、WHtR、VAI是糖尿病前期患病的危险因素;WC、WHtR及VAI预测糖尿病前期患病切点分别为82.5 cm、0.55及1.45;VAI预测糖尿病前期患病的效果优于WC、WHtR。     

Adiposity measures and pre‐diabetes or diabetes in adults with hypertension in Singapore polyclinics

Identification of hypertensive patients with pre‐diabetes or diabetes is important for timely prevention of complications including vascular disease. We aimed to compare the association and discrimination of central obesity measures (waist circumference [WC] and waist‐to‐height ratio [WHtR]) with generalized obesity measure (body mass index [BMI]) in relation to pre‐diabetes and diabetes among a group of Asian hypertensive patients for the first time. We used the baseline data of 925 subjects aged 40 years or older with uncontrolled hypertension recruited at eight primary care clinics in Singapore. Information on height, weight, WC, fasting blood glucose, and hemoglobin A1c (HbA1c) was collected. Pre‐diabetes or diabetes was defined as having reported physician‐diagnosed diabetes or taking anti‐diabetes medication, fasting blood glucose ≥ 5.6 mmol/dL or HbA1c ≥ 5.7%. Among 925 subjects, 495 (53.5%) had pre‐diabetes or diabetes. In logistic regression models, BMI was not associated with pre‐diabetes or diabetes after adjusting for WC or WHtR, while a positive association remained with both WC and WHtR after adjustment of BMI. Both WC and WHtR had significantly better discrimination than BMI (respective area under ROC curve: 0.63 for WC, 0.63 for WHtR, and 0.60 for BMI; P = 0.019), and adding WC or WHtR on top of BMI further correctly reclassified 42.7% and 38.7% hypertensive patients to the right risk group of pre‐diabetes or diabetes indicated by net reclassification improvement. However, WHtR was not superior to WC. In conclusion, our results suggested that central obesity has stronger association with and better discrimination for pre‐diabetes or diabetes than generalized obesity.     

Predicting metabolic syndrome by anthropometric measures among adults 35–65 years in the west of Iran; a cross sectional study from an Iranian RaNCD cohort data

AimsAnthropometric indices have been proposed for the early detection of metabolic syndrome (MetS) and its risk factors. The present study aimed to determine optimal cutoff points for the Body Mass Index (BMI), Waist Circumference (WC), and Waist Hip Ratio (WHR) in the prediction of MetS.MethodsThis cross-sectional study was performed on 9746 adults 35–65 years, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort. The receiver operating characteristic (ROC) curve analysis was used to compare the predictive validity and determine optimal cutoff values.ResultsThe optimal cutoff points for BMI, WC and WHR were 27.3 kg/m² (AUC: 78.6; 95%CI 77.1, 80.1), 97 cm (AUC: 63.8; 95%CI 60.4, 67.2) and 0.95 (AUC: 75.5; 95% CI 73.9, 77.1), respectively in men for the prediction of MetS. But in women the optimal cutoff points for BMI, WC and WHR were 28.6 kg/m² (AUC: 65.7; 95%CI 62.1, 69.4), 98.1 cm (AUC: 65.6; 95%CI 62.4,68.8) and 0.95 (AUC:62.39; 95%CI 60.9,63.9). The risk of MetS in men and women with a BMI higher than the optimal cutoff point was respectively 2.23 and 2.30 times higher than that in those with a WC lower than the cutoff point.ConclusionsBMI is a better predictor of MetS than WC and WHR in adults 35–65 years. We recommend that the optimal cut off point be set for men 27.3 kg/m² and for women 28.6 kg/m².     

Obesity measures at baseline,their trajectories over time,and the incidence of chronic kidney disease: A 14 year cohort study among Korean adults

Background and aimsWe investigated the association of baseline obesity measures, i.e. body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR), and their trajectories over time with incident chronic kidney disease (CKD).Methods and resultsUtilizing data from 2001 to 2014 for 9796 Korean adults without CKD at baseline, the association of baseline obesity measures with incident CKD was evaluated using logistic regression. Further, among 5605 subjects with repeated measures, the effect of the trajectories in obesity measures on CKD incidence was investigated via Cox regression.Baseline obesity in terms of BMI, WC, and HC increased the odds of incident CKD (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05–1.33; OR 1.22, 95% CI 1.07–1.38; and OR 1.25, 95% CI 1.11–1.41, respectively), while baseline WHR did not show such an association. A “became non-obese” BMI, WC, or WHR trajectory, and a “constantly not large” HC trajectory decreased the hazard of incident CKD (hazard ratio (HR) 0.70, 95% CI 0.50–0.99; HR 0.61, 95% CI 0.40–0.92; HR 0.55, 95% CI 0.35–0.85; and HR 0.81, 95% CI 0.69–0.95, respectively) when compared with a “constantly obese or became obese” trajectory.ConclusionBoth baseline obesity and obesity trajectories over time were associated with CKD incidence. BMI and WC were equally good measures of CKD risk, while WHR was not. Separately examining WC and HC components of WHR (= WC/HC) may explain WHR's inconsistency, and WHR's usefulness as a measure of CKD risk should be reevaluated.     

Predicting the risk of type 2 diabetes through anthropometric indices in Pakistani adults- A sub-analysis of second National diabetes survey of Pakistan 2016–2017 (NDSP-07)

Background and aimExcess adiposity is associated with an increased risk of diabetes. Amongst the various measures of adiposity, the most appropriate one to predict the risk of diabetes remains debatable. Therefore, the aim of this study was to compare the ability of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in predicting type 2 diabetes mellitus (DM) among Pakistani adults.Subjects and methodsThis was the sub-analysis of a large population based Second National Diabetes Survey of Pakistan (NDSP) 2016–2017. With this survey, 10834 individuals were recruited and 4788 individuals fulfilled the inclusion criteria for this sub-analysis (subjects with missing anthropometric details were excluded). Participants were categorized into two groups; subjects with type 2 DM and subjects without DM. Data of participants was collected via pre-designed detailed questionnaire. Clinical and anthropometric measurements were measured using standardized techniques.ResultsOut of 4788 individuals, 3085(64.4%) were non-DM subjects and 1703(35.6%) were type 2 DM subjects with mean age of 39.78 ± 13.79 and 50.38 ± 11.33 years, respectively. Logistic regression analysis revealed a significant association of WC with type 2 diabetes after adjustment for possible confounders. Area under the curve (AUC) of WC was found higher than AUC of BMI and WHR.ConclusionThe findings from second NDSP (2016–2017) demonstrated that WC is a better marker than WHR and BMI in predicting type 2 DM for Pakistani population.     

中国成人体重指数和腰臀围比值分布特征的探讨

目的 探讨中国成人体重指数（ＢＭＩ）和腰臀围比值（ＷＨＲ）的分布特征。方法 从１９９４年全国糖尿病防治协作组资料库中选取１６３５４例具有完整糖耐量试验（ＯＧＴＴ）资料的中国成人（≥２５岁）,按不同性别、不同年龄段（２５～３４岁,３５～５４岁,５５～６４岁,≥６５岁）、不同血糖水平和不同纬度地区（北部、中部和南部）分组进行统计分分析。结果 总体人群男女两性的ＢＭＩ均为２４．３ｋｇ／ｍ＾２以不同年龄段     

中心型肥胖人体测量学指标研究现状

腰围、腰臀比(WHR)、腰围/身高比值(WHtR)均为反映中心型肥胖的体表测量指标,与糖尿病、高血压、冠心病等密切相关,均能预测糖尿病、高血压及心血管疾病的发生,但各指标的预测价值具有种族筹异.大量研究显示WHtR为中国人群最佳的中心型肥胖指标,与糖球病及冠心病危险因素的关联强于体重指数(BMI)或腰围、WHR.临床上应重视对WHtR的应用和进一步研究.     

The effects of physical activity, body mass index (BMI) and waist circumference (WC) on glucose intolerance in older people: A nationwide study from Taiwan

We investigated the gender-specific effects of physical activity, BMI and WC on glucose intolerance in an elderly Taiwanese population (n = 1344) aged 65 and above, who participated in the Elderly Nutrition and Health Survey in Taiwan in 1999-2000. In this cross-sectional study, physical activity was assessed using the Modified Baecke Questionnaire for Older Adults (MBQOA). Categories of physical activity level were defined by tertiles of MBQOA scores. Glucose intolerance in subjects not previously diagnosed with diabetes was categorized according to 2003 American Diabetes Association criteria. After adjustment for potential confounders, physical activity was significantly inversely associated with the presence of undiagnosed type 2 diabetes and impaired fasting glucose (IFG) in older women. In older men, the association was less clear. BMI and WC were significantly positively associated with the presence of undiagnosed diabetes in men and were significantly associated with IFG in both sexes. In older women, undiagnosed diabetes was strongly associated with increased WC, but not with BMI. Our findings highlight that older women with low physical activity or high WC, and older men with high BMI or WC are important target populations for interventions to prevent glucose intolerance.     

Waist circumference and impaired fasting glucose screening in a Mediterranean population

We evaluate the merits of routine waist circumference measurements for screening of impaired fasting glucose (IFG). Waist circumference and body mass index showed a strong association with the risk of IFG. The present data indicate the need for routine anthropometric measurements in clinical practice screening for IFG.     

The influence of regional adiposity on atherogenic risk factors in men and women with type 2 diabetes.

To determine firstly whether body fat distribution could predict the presence of atherogenic risk factors better than overall adiposity in Type 2 diabetes, and secondly whether sex differences in these risk factors could be explained by sex differences in fat distribution, waist-to-hip girth ratio (WHR), serum lipids, lipoproteins, apolipoproteins, plasma lipolytic activity, and blood pressure were assessed in 47 patients with Type 2 diabetes, 21 women matched for age, body mass index (BMI) and blood glucose control with 26 men. The men had higher WHR (0.95 (range 0.83-1.07) vs 0.82 (0.74-0.94), p less than 0.001), lower HDL-cholesterol (1.03 +/- 0.05 vs 1.38 +/- 0.06 mmol l-1, p less than 0.001) and apolipoprotein A1 (1.40 +/- 0.06 vs 1.76 +/- 0.06 gl-1, p less than 0.001) concentrations, and higher hepatic lipase activities (16.2 (6.4-38.0) vs 8.6 (2.3-23.1) mmol h-1 l-1, p less than 0.01). In both men and women, BMI and WHR were positively related to serum triglyceride, insulin and C-peptide concentrations. In women, HDL-cholesterol was negatively related to BMI (r = -0.45, p less than 0.05) but only possibly related to WHR (r = -0.33, NS). In men, by contrast, WHR was related negatively to HDL-cholesterol (r = -0.60, p less than 0.005), HDL2-cholesterol (r = -0.43, p less than 0.05), and apolipoprotein A1 (r = -0.70, p less than 0.001) and positively to hepatic lipase activity (r = 0.65, p less than 0.001), whereas the same relationships with BMI were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)     

Central obesity in Yemeni children: A population based cross-sectional study

AIM: To establish percentile curves and to explore prevalence and correlates of central obesity among Yemeni children in a population based cross-sectional study.METHODS: A representative sample of 3114 Yemeni children(1564 boys,1550 girls) aged 6-19 years participating in the HYpertension and Diabetes in Yemen study was studied.Data collection was conducted at home by survey teams composed of two investigators of both genders.Study questionnaire included questions about demographics,lifestyle,and medical history.Anthropometric measurements included body weight,height,waist circumference(WC) and hip circumferences.Waist to hip ratio(WHR) and waist-toheight ratio(WHtR) were then calculated.Age and gender specific smoothed percentiles of WC,WHR,and WHtR were obtained using lambda-mu-sigma parameters(LMS method).The independent predictors of central obesity defined as(1) WC percentile ≥ 90th;(2) WHtR ≥ 0.5;or(3) WC percentile ≥ 90thand WHtR ≥ 0.5,were identified at multivariate logistic regression analysis adjusted for age,gender,urban/rural location,years of school education,sedentary/active life-style.RESULTS: Percentile curves for WC,WHR and WHtR are presented.Average WC increased with age for both genders.Boys had a higher WC than girls until early adolescence and thereafter girls had higher values than boys.WHR decreased both in boys and girls until early adolescence.Thereafter while in boys it plateaued in girls it continued to decrease.Mean WHtR decreased until early adolescence with no gender related differences and thereafter increased more in girls than in boys towards adult age.Prevalence of central obesity largely varied according to the definition used which was 10.9% for WC ≥ 90thpercentile,18.3% for WHtR ≥ 0.5,and 8.6% when fulfilling both criteria.At adjusted logistic regression WC ≥ 90thpercentiles and WHtR ≥ 0.5 were less prevalent in rural than in urban areas(OR = 0.52,95%CI: 0.41-0.67 and 0.66,0.54-0.79 respectively),being more prevalent in children with sedentary lifestyle rather than an active one(1.52,95%CI: 1.17-1.98 and 1.42,95%CI: 1.14-1.75,respectively).CONCLUSION: Yemeni children central obesity indicespercentile curves are presented.Central obesity prevalence varied according to the definition used and was more prevalent in urban sedentary subjects.     

超重和肥胖人群血清脂联素水平与2型糖尿病的关系

目的研究血清脂联素水平与超重、肥胖及与血糖（PG）的关系。方法对深圳地区21～60岁人群共29799人进行BMI，腰围（WC），腰臀围比（WHR）及血糖检测，按BMI高低分成三大组：正常非肥胖（NC）组（BMI≤24）男10267人、女14268人；超重（OW）组（24〈BMI〈28）男2952人、女1800人；和肥胖（Ob）组（BMI≥28）男245人、女267人。Ob组按血糖水平又分为单纯肥胖（S-Ob）组（男190人，女216人）和2型糖尿病肥胖（T2DM-Ob）组（男55人，女51人）。调查三大组人群T2DM的患病率，分析BMI、WC、WHR与T2DM的关系，并测定各组人群的血清脂联素水平。结果T2DM的患病率在NC组男性和女性分别为32‰和35‰；在OW组的男性和女性分别为126‰和106‰；在肥胖组的男性和女性分别为225‰和191‰。T2DM的患病率在男性WC〉85cm者显著高于WC≤85cm者，在女性，WC〉80cm者显示高于WC≤80cm者（P均〈0．01）。血清脂联素浓度在Ow组、Ob组及T2DM—Ob组均显著低于NC组（P=0．000）。在T2DM—Ob患者中，脂联素浓度与BMI、WC、WHR、PG呈显著负相关。结论脂联素浓度变化可能与肥胖及糖尿病密切相关。保持BMI和WC在正常范围，是预防糖尿病发生的有效措施之一。