title: Anthropometric measures and glucose levels in a large multi-ethnic cohort of individuals at risk of developing type 2 diabetes.
abstract: OBJECTIVE
  We determined: (1) which of BMI, waist circumference, hip circumference and WHR has the strongest association and explanatory power for newly diagnosed type 2 diabetes and glucose status; and (2) the impact of considering two measures simultaneously. We also explored variation in anthropometric associations by sex and ethnicity.
  
  
  METHODS
  We performed cross-sectional analysis of 22,293 men and women who were from five ethnic groups and 21 countries, and at risk of developing type 2 diabetes. Standardised anthropometric associations with type 2 diabetes and AUC of glucose status from OGTT (AUC(OGTT)) were determined using multiple regression. Explanatory power was assessed using the c-statistic and adjusted r (2).
  
  
  RESULTS
  An increase in BMI, waist circumference or WHR had similar positive associations with type 2 diabetes, AUC(OGTT) and explanatory power after adjustment for age, sex, smoking and ethnicity (p < 0.01). However, using BMI and WHR together resulted in greater explanatory power than with other models (p < 0.01). Associations were strongest when waist circumference and hip circumference were used together, a combination that had greater explanatory power than other models except for BMI and WHR together (p < 0.01). Results were directionally similar according to sex and ethnicity; however, significant variations in associations were observed among these subgroups.
  
  
  CONCLUSIONS
  The combination of BMI and WHR, or of waist circumference and hip circumference has the best explanatory power for type 2 diabetes and glucose status compared with a single anthropometric measure. Measurement of waist circumference and hip circumference is required to optimally identify people at risk of type 2 diabetes and people with elevated glucose levels.
authors.affiliation: The Population Health Research Institute, McMaster University, Hamilton, ON, Canada.
authors.forename: L
authors.initials: L
authors.lastname: de Koning
authors.forename: H C
authors.initials: HC
authors.lastname: Gerstein
authors.forename: J
authors.initials: J
authors.lastname: Bosch
authors.forename: R
authors.initials: R
authors.lastname: Diaz
authors.forename: V
authors.initials: V
authors.lastname: Mohan
authors.forename: G
authors.initials: G
authors.lastname: Dagenais
authors.forename: S
authors.initials: S
authors.lastname: Yusuf
authors.forename: S S
authors.initials: SS
authors.lastname: Anand
mesh_terms: D000328:Adult; D001786:Blood Glucose; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose