Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study.
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.
Balkau
B
B
INSERM, U258, Villejuif, France. balkau@vjf.inserm.fr
Sapinho
D
D
Petrella
A
A
Mhamdi
L
L
Cailleau
M
M
Arondel
D
D
Charles
M A
MA
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