Anthropometric discriminators of type 2 diabetes among White and Black American adults.
BACKGROUND
The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample.


METHODS
We used Atherosclerosis Risk in Communities study baseline data (1987-89) from 15 242 participants (1827 with T2DM) aged 45-65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist:  height ratio (WHtR), and waist:  hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models.


RESULTS
Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race-gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults.


CONCLUSIONS
Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race-gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females.
Institute of Public and Preventive Health, Augusta University, Augusta, Georgia.
Dale S
DS
Hardy
School of Nursing, Saint Louis University, Tucson, Arizona, USA.
Devita T
DT
Stallings
College of Nursing, Augusta University, Augusta, Georgia.
Jane T
JT
Garvin
Department of Family and Community Medicine, College of Medicine, University of Arizona, USA.
Francine C
FC
Gachupin
Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia.
Hongyan
H
Xu
Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, Tucson, Arizona, USA.
Susan B
SB
Racette
D001741:Black or African American; D000886:Anthropometry / Q000379:methods*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014481:United States; D055105:Waist Circumference; D065927:Waist-Height Ratio; D049629:Waist-Hip Ratio; D044465:White People
gender; obesity; race; type 2 diabetes; 性别,肥胖,种族,2型糖尿病