Optimal Cut-off Points of BMI WC and WHR for Screening of Pre-Diabetes and Diabetes Over 35 Years Old People

Abstract

Using BMI, WC and WHR to investigate and compare these screening tool for IFG, IGT and diabetes subjects in Shanghai China; and to identify the optimal cutoff points of BMI, WC and WHR for screening pre-diabetes (Pre-DM) and diabetes (DM) over 35 years old people. Totally 3,195 aged 35 years old and above people who attended community epidemiological survey of diabetes mellitus. Using ADA criteria (2010), the participants were classified as normal, Pre-DM or DM according to test results of blood glucose. The area under ROC curve (AUROC) for BMI, WC and WHR were calculated; as well as the sensitivity, specificity and Youden index under different BMI or WHR cutoff points. Among these people, age is (61.07±10.08), and BMI and WHR are respectively (25.12±3.29) and (0.87±0.06). The positive rate of screening of DM is 11.36% and that of Pre-DM is 38.57%. There are correlation between blood glucose and BMI or WHR (p<0.05). With the increase of BMI or WHR cutoff point, the screening sensitivity (YI, Sp and Se) for DM or pre-DM are decreasing; but the area under ROC (AUROC) increases firstly and then decreases (inflection point: WHR≥0.8~0.9 and BMI≥23 for pre-DM, WHR≥0.9 and BMI≥24 for DM). The combined screening efficacy of BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8), and YI is the highest. Using HbA1C as standard of judgment seems to be better than blood glucose in screening for DM. BMI≥23, WC≥90 cm or WHR≥0.8 is the optimal cutoff point for screening DM and pre-DM, and the screening efficacy of BMI is better than WC and WHR. BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8). HbA1C is better than FBG and OGTT as standard of judgment in screening.

Effectiveness of Anthropometric Measurements for Identifying Diabetes and Prediabetes among Civil Servants in a Regional City of Northern Ethiopia: A Cross-Sectional Study

“…e result showed that the WC and BMI cut-off point for women with diabetes is lower compared to prediabetes, which implies that higher WC gives lower risk of developing prediabetes similarly with the community epidemiological survey with the increase of the BMI cut-off point; the screening sensitivity for prediabetes is decreasing [41]. However, in a population-based study in women, the BMI cut-off point for predicting prediabetes was similar to the one for diabetes, but WC cut-off point was considerably higher [42].…”

Effects of aerobic and resistance exercise on glycosylated hemoglobin (HbA1c) concentrations in non-diabetic Taiwanese individuals based on the waist-hip ratio

“…Its measurement is essential for long-term glucose control, where a concentration of less than 7% is considered the target for good control in most cases with diabetes [ 3 ]. According to the 2009 International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes, HbA1c is considered a more stable biological index than fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) [ 4 , 5 ].…”