title: Comparison of anthropometric indices of obesity in predicting subsequent risk of hyperglycemia among Chinese men and women in Mainland China.
abstract: BACKGROUND
  Obesity is a strong risk factor for hyperglycemia. However, the performance of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and body mass index (BMI) in predicting hyperglycemia was inconclusive; and ethnic differences may exist in the associations.
  
  
  OBJECTIVE
  The objective was to compare WHtR, WC, WHR and BMI in predicting hyperglycemia among Chinese adults and identify optimal cut-off points.
  
  
  METHODS
  A community-based prospective cohort study was conducted during 2004-2007 in Nanjing China. WHtR, WC, WHR, BMI, fasting capillary blood glucose, covariates and potential confounders were assessed at baseline and third year of follow-up.
  
  
  RESULTS
  The overall cumulative incidence of hyperglycemia was 8.6% (8.0% in men, 9.0% in women). Relative risks across quartiles of WHtR, WHR, WC and BMI were 1.00, 1.33, 1.67, 3.40; 1.00, 2.38, 2.53, 3.87; 1.00, 1.29, 1.75, 2.90; and 1.00, 1.45, 1.49, 2.41 in men, and 1.00, 1.24, 1.99, 2.87; 1.00, 1.14, 2.28, 2.66; 1.00, 1.32, 1.80, 3.14; and 1.00, 1.39, 1.50, 2.08 in women, respectively. p for trend was <0.01 for each marker and gender. Adjustment for potential confounders did not change such dose-response relationships materially. ROC analysis indicated that WHtR had the best sum of sensitivity and specificity compared to the other measures .Optimal cut-offs for WHtR, WHR, WC and BMI were 0.51, 0.92, 85 and 24 for men, while 0.55, 0.86, 82 and 25 for women, respectively.
  
  
  CONCLUSIONS
  WHtR, WHR, WC and BMI were positively associated with subsequent hyperglycemia. WHtR and WC best predicted hyperglycemia among Chinese adults.
authors.affiliation: Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China. f.xufei@gmail.com
authors.forename: Fei
authors.initials: F
authors.lastname: Xu
authors.forename: You Fa
authors.initials: YF
authors.lastname: Wang
authors.forename: Lingeng
authors.initials: L
authors.lastname: Lu
authors.forename: Yaqiong
authors.initials: Y
authors.lastname: Liang
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Hong
authors.forename: Jiequan
authors.initials: J
authors.lastname: Li
mesh_terms: D000886:Anthropometry / Q000379:methods*; D015992:Body Mass Index; D015984:Causality; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D055105:Waist Circumference; D049629:Waist-Hip Ratio