title: Prevalence of diabetes and predictions of its risks using anthropometric measures in southwest rural areas of China.
abstract: BACKGROUND
  To examine the prevalence of diabetes and prediabetes in Songming county, Yunnan province, South-west China and examine influences of anthropometric indicators on diabetic risk.
  
  
  METHODS
  This study was a population based cross-sectional study of 1031 subjects in Songming County aged 30 years and older. Age-standardization was performed by using the 2010 Songming population as the standard population. After an overnight fasting, participants underwent an oral glucose tolerance test (OGTT), and venous blood glucose levels were measured to identify diabetes and prediabetes. Physicians completed questionnaires and blood pressure measurements; trained nurses measured anthropometric variables. Age-adjusted logistic regression models were used to assess the association between anthropometric variables and diabetes.
  
  
  RESULTS
  Total prevalences of diabetes and prediabetes were 10.0% and 11.6%, respectively. In women, prevalence of diabetes and prediabetes significantly increased with body mass index (BMI),waist hip ratio (WHR), and waist-to-height ratio (WHtR). But in men, prevalence of diabetes and prediabetes only significantly increased with WHR and WHtR. Compared to 1st WHR tertile in women, there was a nearly tenfold increase in the risk of diabetes with 3rd WHR tertile (OR 10.50, 95% CI 3.95-27.86). Men with 3rd BMI tertile had 4.8-fold risk of getting diabetes compared to men with 1st WHtR tertile (OR 4.79, 95% CI 1.88-12.26). Only WHtR had significantly higher receiver operating characteristic (ROC) area than BMI in total men (0.668 vs. 0.561, p < 0.05). And in total women, only WHR had significantly higher ROC area than BMI (0.723 vs. 0.628, p < 0.05). In the partial correlation analysis controlling for waist circumference, only WHR had significant correlation with fasting plasma glucose (r = 0.132, p = 0.002) and 2-h plasma glucose (r = 0.162, p = 0.000) in women, and WHtR had a much stronger association with both fasting plasma glucose (r = 0.305, P = 0.000) and 2 h plasma glucose (r = 0.303, P = 0.000) than WHR in men.
  
  
  CONCLUSIONS
  High prevalence of diabetes and prediabetes were found in this underdeveloped region. About half of total subjects with diabetes were undiagnosed. The association of obesity indices and diabetic risk factors varied with gender. The strongest predictors of diabetes were WHR for the female subgroup and WHtR for the male subgroup.
authors.affiliation: Department of Endocrinology & Metabolism, Huashan Hospital, Medical College Fudan University, Shanghai, China. xiaolongzhao@163.com
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Zhao
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Zhu
authors.forename: Hengsheng
authors.initials: H
authors.lastname: Zhang
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhao
authors.forename: Jinhui
authors.initials: J
authors.lastname: Li
authors.forename: Yonghui
authors.initials: Y
authors.lastname: Shu
authors.forename: Songwu
authors.initials: S
authors.lastname: Li
authors.forename: Minghui
authors.initials: M
authors.lastname: Yang
authors.forename: Linghu
authors.initials: L
authors.lastname: Cai
authors.forename: Jiping
authors.initials: J
authors.lastname: Zhou
authors.forename: Yiming
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000886:Anthropometry / Q000379:methods*; D001827:Body Height; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D017678:Sex Distribution; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult