title: Optimal anthropometric measures and thresholds to identify undiagnosed type 2 diabetes in three major Asian ethnic groups.
abstract: To identify optimal anthropometric measures and cutoffs to identify undiagnosed diabetes mellitus (UDM) in three major Asian ethnic groups (Chinese, Malays, and Asian-Indians).
  
  
  
  Cross-sectional data were analyzed from 14,815 ethnic Chinese, Malay, and Asian-Indian participants of the Singapore National Health Surveys, which included anthropometric measures and an oral glucose tolerance test. Receiver operating characteristic curve analyses were used with calculation of the area under the curve (AUC) to evaluate the performance of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) for the identification of UDM.
  
  
  
  BMI performed significantly worse (AUCMEN  = 0.70; AUCWOMEN  = 0.75) than abdominal measures, whereas WHTR (AUCMEN  = 0.76; AUCWOMEN  = 0.79) was among the best performing measures in both sexes and all ethnic groups. Anthropometric measures performed better in Chinese than in Asian-Indian participants for the identification of UDM. A WHTR cutoff of 0.52 appeared optimal with a sensitivity of 76% in men and 73% in women and a specificity of 63% in men and 70% in women.
  
  
  
  Although ethnic differences were observed in the performance of anthropometric measures for the identification of UDM, abdominal adiposity measures generally performed better than BMI, and WHTR performed best in all Asian ethnic groups.
authors: NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors: Derrick Johnston
authors: 0000-0002-5680-1056
authors: DJ
authors: Alperet
authors: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.|Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore.
authors: Wei-Yen
authors: WY
authors: Lim
authors: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.|Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore.
authors: Derrick
authors: D
authors: Mok-Kwee Heng
authors: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.|Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore.
authors: Stefan
authors: S
authors: Ma
authors: NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore. rob_martinus_van_dam@nuhs.edu.sg.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore. rob_martinus_van_dam@nuhs.edu.sg.|Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore. rob_martinus_van_dam@nuhs.edu.sg.
authors: Rob M
authors: RM
authors: van Dam
mesh_terms: D000328:Adult; D044466:Asian People; D001786:Blood Glucose; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000503:physiopathology; D005006:Ethnicity; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012846:Singapore; D055105:Waist Circumference / Q000502:physiology*; D065927:Waist-Height Ratio; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose