Abstract
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 < 0.0001) except ABSI, which was not significant in White and Black males. Statistically significant hazard ratios ranged from 1.26–1.63 for males and 1.15–1.88 for females. In general, the largest hazard ratios were those that corresponded to the highest Harrell’s C-Index and lowest Akaike Information Criteria values. Among White and Black males and females, BMI, WC, WHR, and WHtR were comparable in discriminating cases from non-cases of T2DM. ABSI, BAI, and WHHR were inferior discriminators of incident T2DM across all race-gender groups.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.
Highlights
Obesity is one of the major risk factors for type 2 diabetes (T2DM)
Higher values of all anthropometric measures increased the risk for development of T2DM (p < 0.0001) except a body shape index (ABSI), which was not significant in White and Black males
Among White and Black males and females, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), and waist to height ratio (WHtR) were comparable in discriminating cases from non-cases of T2DM
Summary
85% of the U.S population with T2DM is either overweight or obese [1]. If this trend continues, one in three adults in the U.S will have diabetes by 2050 [1]. Anthropometric measures serve as proxies to visceral and subcutaneous abdominal adipose tissues, which are associated with insulin resistance and metabolic abnormalities [2,3]. These metabolic abnormalities may differ across race-gender groups. Subcutaneous adipose tissue volume tends to be higher in women than men [7]
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