Anthropometric discriminators of type 2 diabetes among White and Black American adults

BACKGROUND: The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample. METHODS: We used Atherosclerosis Risk in Communities study baseline data (1987–89) from 15 242 participants (1827 with T2DM) aged 45–65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist:height ratio (WHtR), and waist:hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models. RESULTS: Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race–gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults. CONCLUSIONS: Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race–gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females

Best anthropometric discriminators of incident type 2 diabetes among white and black adults: A longitudinal ARIC study.

ObjectiveTo determine which anthropometric measures are the strongest discriminators of incident type 2 diabetes (T2DM) among White and Black males and females in a large U.S. cohort.MethodsWe used Atherosclerosis Risk in Communities study data from 12,121 participants aged 45-64 years without diabetes at baseline who were followed for over 11 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and waist to hip to height ratio (WHHR). All anthropometric measures were repeated at each visit and converted to Z-scores. Hazard ratios and 95% confidence intervals adjusted for age were calculated using repeated measures Cox proportional hazard regression analysis. Akaike Information Criteria was used to select best-fit models. The magnitude of the hazard ratio effect sizes and the Harrell's C-indexes were used to rank the highest associations and discriminators, respectively.ResultsThere were 1,359 incident diabetes cases. Higher values of all anthropometric measures increased the risk for development of T2DM (p ConclusionsBMI, the most commonly used anthropometric measure, and three anthropometric measures that included waist circumference (i.e., WC, WHR, WHtR) were the best anthropometric discriminators of incident T2DM across all race-gender groups in the ARIC cohort

Hazard ratios for incident type 2 diabetes, by anthropometric measure: The ARIC study.

<p>Hazard ratios for incident type 2 diabetes, by anthropometric measure: The ARIC study.</p

Harrell’s C-Index for incident type 2 diabetes by anthropometric measure: The ARIC study.

<p>Harrell’s C-Index for incident type 2 diabetes by anthropometric measure: The ARIC study.</p

Forest plot of hazard ratios by race-gender groups: The ARIC study.

<p>Abbreviations: ARIC, Atherosclerosis Risk in Communities; a body shape index (ABSI), body adiposity index (BAI), body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), and waist to hip to height ratio (WHHR). Individual models using repeated measures survival analysis were constructed with T2DM status (yes/no) as the response, with each anthropometric measure as the exposure variable, adjusted for age (5-year increments), over 4 visits (baseline: 1987–1989, visit 2: 1990–1992, visit 3: 1993–1995, visit 4: 1996–1998) using Atherosclerosis Risk in Communities study data.</p