SUN-161 Association between Anthropometric Parameters and Recent Diagnosis of Type 2 Diabetes Mellitus in Adult Patients Attended at a General Hospital in Peru

Abstract

Type 2 Diabetes mellitus (T2DM) is a major public health problem worldwide and its early diagnosis is a challenge, because it’s usually asymptomatic. Therefore, the possibility of using anthropometric parameters (AP) for detection of patients at risk is considered, because are simple to measure and cost effective. The objective was to determine whether the AP: Body Mass Index (BMI), Waist Circumference (WC), Neck Circumference (NC) and Waist-Length Index (WLI) are factors associated with the recent diagnosis of T2DM and determine the cut points for each AP, according to sex. This is a cross-sectional, analytical study, which included 18-70 years old patients, both sexes, who attended for the first time at the endocrinology department for general evaluation during the period January 2016 - January 2017. Were made anthropometric measurements and biochemical studies (oral glucose tolerance test-75g and glycosylated hemoglobin) to diagnose T2DM, according to American Diabetes Association criteria. Were excluded: pregnant, prediabetes or T2DM previous, in hyperglycemic crisis, any thyroid disease including goiter, renal failure, chronic liver disease, heart failure or hypoalbuminemia and lost weight in the last 3 months. For anthropometric measurements, standard stipulated methods were used. To determine association between the AP and the diagnosis of T2DM, the prevalence ratio (PR) of each AP was calculated with CI 95% using Poisson regressions. ROC curve analysis was performed to establish the cut-off points with the best balance of (S) and (E) estimating the youden index. Statistical package Stata version 14.0 was used. We evaluated data from 698 patients: 411 women and 287 men. The average age was 40.9 years old in women and 43.1 years old in men. 10.2% of women and 18.1% of men were diagnosed with T2DM. NC (PR: 1.23 CI95%: 1.15 – 1.31 in women, PR: 1.12 CI95%: 1.06 - 1.19 in men), BMI (PR: 1.13 CI95%: 1.09 - 1.17 in women, PR: 1.06 CI95%: 1.02 - 1.11 in men) and WC (PR: 1.07 CI95%: 1.05 - 1.09 in women, PR: 1.03 CI95%: 1.02 - 1.05 in men) were associated with T2DM diagnosis; whereas WLI was not associated (PR: 1.02 CI95%: 0.99 - 1.06 in women, PR: 0.93 CI95%: 0.94 - 1.00 in men). In ROC curves analysis, the AUC was higher for NC and WC, intermediate for BMI, and lower for WLI; in both sexes. For NC, the cutoff point found was 38cm (S: 0.63 E: 0.70) and 42cm (S: 0.73 E: 0.59), for WC it was 101cm (S: 0.68 E: 0.73) and 108cm (S: 0.59 E: 0.70), for BMI it was 30.2 kg/m2 (S: 0.69 E: 0.66) and 32.4kg/m2 (S: 0.44 E: 0.75), for WLI it was 0.63 (S: 0.55 E: 0.60) and 0.66 (S: 0.90 E: 0.25) in women and men respectively. Finally we conclude that AP associated with the recent diagnosis of T2DM were: NC, BMI and WC, with the NC and WC being the parameters with the highest detection capacity for both sexes. Therefore NC constitutes a tool to be considered in the identification of patients at risk of T2DM, taking into account that it is easier to measure.