Strong Association of Waist Circumference (WC), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Waist-to-Hip Ratio (WHR) with Diabetes: A Population-Based Cross-Sectional Study in Jilin Province, China

Abstract

Backgrounds. The prevalence of diabetes has increased with the increase of obesity, and finding indicators to predict diabetes risk has become an urgent need. The purpose of this study is to compare the correlation between four anthropometric indices and the prevalence of diabetes. Methods. A total of 4052 participants aged 40 years and above were selected in Dehui City, Jilin Province, using a multistage stratified whole group sampling method. Face-to-face interviews and physical examinations were conducted. Multivariate logistic analysis was used. The values of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were divided into quartiles (Q1: <25%; Q2: ~25%; Q3: ~50%; and Q4: ~75%). The median of each quartile was used for a linear trend test. Results. For all four body fat-measuring indices of body mass index (adjusted OR: 3.300, 95% CI: 2.370, 4.595), WC (adjusted OR: 5.131, 95% CI: 3.433, 7.669), WHR (adjusted OR: 3.327, 95% CI: 2.386, 4.638), and WHtR (adjusted OR: 5.959, 95% CI: 3.922, 9.054), patients in the highest quartile were more likely to have diabetes than those in the lowest quartile. The areas under the curve of WHtR, WC, WHR, and BMI for diabetes were 0.683, 0.669, 0.654, and 0.629, respectively. In female participants, the areas under the curve of the waist-height ratio and WC were 0.710 (95% CI: 0.679-0.741) and 0.701 (95% CI: 0.670-0.732), respectively. Conclusions. The WC and WHtR were more closely related to diabetes than BMI and WHR among study participants ≥ 40 years of age, especially in females.

Association of body mass index and waist circumference with type 2 diabetes mellitus in older adults: a cross-sectional study

“…Our study found that BMI and WC were positively associated with T2DM, and those positive associations were also found in some other studies [ 9 , 24 , 25 ]. There are several explanations for this positive association.…”

Risk factors for hypertension and diabetes comorbidity in a Korean population: A cross-sectional study

“…Issaka et al [34] argued that WC might be the indicator most helpful in identifying those with diabetes among West African adults. However, recently, several studies introduced WHtR as a risk indicator for diabetes because it is reasonable to assume that short subjects generally have more risk factors related to abdominal fat than tall subjects with a similar WC [37][38][39][40][41][42][43]. Bell et al [28] noted that BMI was associated with a higher prevalence of hypertension in a crosssectional study of adults aged 30-65 years in China, the Philippines, and the United States.…”

“…In addition, WC is an indicator that can reflect abdominal obesity well and has been mentioned as a risk factor for diabetes [31][32][33][34] and hypertension [35,36]. However, WC does not consider height, and WHtR, which reflects the ratio of WC to height, has recently been reported as a risk factor for diabetes [37][38][39][40][41][42][43] and hypertension [30,36,44,45]. These obesity-related indicators are also known as risk factors for HDC [46][47][48].…”

Association of Anthropometric Indices With the Development of Diabetes Among Hypertensive Patients in China: A Cohort Study

“…Although the mentioned anthropometric indices have been used in various studies, their usefulness has not been systematically evaluated. Furthermore, previous studies mostly are cross-sectional designed and focus on the diabetes risk among general populations ( 17 , 18 ), lacking concern for the hypertensive patients, especially those with normal-weight central obesity.…”