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. 2017 Oct:132:36-44.
doi: 10.1016/j.diabres.2017.07.022. Epub 2017 Jul 22.

Comparison of relationships between four common anthropometric measures and incident diabetes

Crystal Man Ying Lee  1 , Mark Woodward  2 , Nirmala Pandeya  3 , Robert Adams  4 , Elizabeth Barrett-Connor  5 , Edward J Boyko  6 , Mats Eliasson  7 , Laercio J Franco  8 , Wilfred Y Fujimoto  9 , Clicerio Gonzalez  10 , Barbara V Howard  11 , David R Jacobs Jr  12 , Sirkka Keinanen-Kiukaanniemi  13 , Dianna Magliano  14 , Pamela Schreiner  13 , Jonathan E Shaw  14 , June Stevens  15 , Anne Taylor  16 , Jaakko Tuomilehto  17 , Lynne Wagenknecht  18 , Rachel R Huxley  19 ; Obesity, Diabetes and Cardiovascular Disease Collaboration
Affiliations

Comparison of relationships between four common anthropometric measures and incident diabetes

Crystal Man Ying Lee et al. Diabetes Res Clin Pract. 2017 Oct.

Abstract

Aims: First, to conduct a detailed exploration of the prospective relations between four commonly used anthropometric measures with incident diabetes and to examine their consistency across different population subgroups. Second, to compare the ability of each of the measures to predict five-year risk of diabetes.

Methods: We conducted a meta-analysis of individual participant data on body mass index (BMI), waist circumference (WC), waist-hip and waist-height ratio (WHtR) from the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox proportional hazard models were used to estimate the association between a one standard deviation increment in each anthropometric measure and incident diabetes. Harrell's concordance statistic was used to test the predictive accuracy of each measure for diabetes risk at five years.

Results: Twenty-one studies with 154,998 participants and 9342 cases of incident diabetes were available. Each of the measures had a positive association with incident diabetes. A one standard deviation increment in each of the measures was associated with 64-80% higher diabetes risk. WC and WHtR more strongly associated with risk than BMI (ratio of hazard ratios: 0.95 [0.92,0.99] - 0.97 [0.95,0.98]) but there was no appreciable difference between the four measures in the predictive accuracy for diabetes at five years.

Conclusions: Despite suggestions that abdominal measures of obesity have stronger associations with incident diabetes and better predictive accuracy than BMI, we found no overall advantage in any one measure at discriminating the risk of developing diabetes. Any of these measures would suffice to assist in primary diabetes prevention efforts.

Keywords: Body mass index; Diabetes; Waist circumference.

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Figures

Fig. 1
Fig. 1. Age, sex and study adjusted hazard ratios for incident diabetes by fifths for (a) body mass index (BMI); (b) waist circumference (WC); (c) waist-hip ratio (WHR); (d) waist-height ratio (WHtR)
Fig. 2
Fig. 2
2a – Age, sex, family history of diabetes and smoking adjusted hazard ratios for incident diabetes associated with one standard deviation increment in each anthropometric measure by sex*, baseline age†, fasting plasma glucose, and known diabetes rate subgroups. BMI = body mass index; WC = waist circumference; WHR = waist-hip ratio; WHtR = waist-height ratio; CI = confidence intervals. *Not adjusted for sex, †Not adjusted for age. 2b – Age, sex, family history of diabetes and smoking adjusted hazard ratios for incident diabetes associated with one standard deviation increment in each anthropometric measure by race/ethnicity subgroup. BMI = body mass index; WC = waist circumference; WHR = waist-hip ratio; WHtR = waist-height ratio; CI = confidence intervals.
Fig. 2
Fig. 2
2a – Age, sex, family history of diabetes and smoking adjusted hazard ratios for incident diabetes associated with one standard deviation increment in each anthropometric measure by sex*, baseline age†, fasting plasma glucose, and known diabetes rate subgroups. BMI = body mass index; WC = waist circumference; WHR = waist-hip ratio; WHtR = waist-height ratio; CI = confidence intervals. *Not adjusted for sex, †Not adjusted for age. 2b – Age, sex, family history of diabetes and smoking adjusted hazard ratios for incident diabetes associated with one standard deviation increment in each anthropometric measure by race/ethnicity subgroup. BMI = body mass index; WC = waist circumference; WHR = waist-hip ratio; WHtR = waist-height ratio; CI = confidence intervals.
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