title: Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study.
abstract: OBJECTIVE
  To compare the sensitivities of BMI, waist circumference and waist hip ratio (WHR) in identifying subjects who should be screened for diabetes and/or for obesity-associated dyslipidaemia.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Central-western France.
  
  
  METHODS
  More than 3000 men and women, aged 40-64 years, from the French study: data from an epidemiological study on the insulin resistance syndrome (D.E.S.I.R.).
  
  
  METHODS
  Sensitivity and specificity for screened diabetes (fasting plasma glucose>or=7.0 mmol/l) and screened dyslipidaemia (triglycerides>or=2.3 mmol/l and/or HDL-cholesterol <0.9/1.1 mmol/l (men/women)) according to BMI, waist circumference and WHR.
  
  
  RESULTS
  Sensitivities increased as more corpulent subjects were screened, but they increased slowly after screening the top 30%: body mass index (BMI)>or=27/26 kg/m(2) (men/women) or waist >or=96/83 cm or WHR>or=0.96/0.83. These values were chosen as thresholds. In men, BMI had a nonsignificantly higher sensitivity than waist or WHR for both diabetes and dyslipidaemia (77 vs 74 and 66% P<0.3, 0.09; 56 vs 54 and 49% P<0.5, 0.16). For women, waist had a slightly higher sensitivity than BMI or WHR (82 vs 77 and 77% P<0.8, 0.7) for diabetes; for dyslipidaemia, waist and WHR had similar sensitivities, higher than for BMI (65 and 67 vs 54% P<0.16, 0.13).
  
  
  CONCLUSIONS
  We propose that for screening in a French population 40-64 years of age, the more obese 30% of the population, identified either by BMI, waist or WHR be screened for diabetes and obesity-associated dyslipidaemia.
authors.affiliation: INSERM, U258, Villejuif, France. balkau@vjf.inserm.fr
authors.forename: B
authors.initials: B
authors.lastname: Balkau
authors.forename: D
authors.initials: D
authors.lastname: Sapinho
authors.forename: A
authors.initials: A
authors.lastname: Petrella
authors.forename: L
authors.initials: L
authors.lastname: Mhamdi
authors.forename: M
authors.initials: M
authors.lastname: Cailleau
authors.forename: D
authors.initials: D
authors.lastname: Arondel
authors.forename: M A
authors.initials: MA
authors.lastname: Charles
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D049629:Waist-Hip Ratio