Predicting Value of Waist-to-height Ratio on Diabetes Incidence: A Population-Based Longitudinal Study

Abstract

Aims To evaluate the association between waist to height ratio (WHtR) and incident type 2 diabetes （T2DM）and compared its predictive power with that of other anthropometric indices in East Asian population. Methods 15464 people took part in this research. Participants were further divided into twelve subgroups according to age, WHtR, and sex. Multivariable. Cox regression analysis assessed the relationship between WHtR and incident T2DM. Restricted cubic splines were used to determine the shape of the association. The predictive power of the WHtR was examined and directly compared with other indices, using the area under the receiver operating characteristic curve (AUC). Results After a median follow-up of 5.4 years, 2.4% (373/15,464) participants developed diabetes. The incidence of diabetes increased with ascending WHtR (P< 0.001).Cox logistic regression analysis displayed that after adjusting for confounding factors, WHtR was significantly associated with the incidence of T2DM. In the restricted cubic spline models, WHtR exhibited U-shaped relationships with T2DM in the middle-aged and elderly men groups, but J-shaped associations with T2DM in both the women and young men groups. Compared with BMI and WC, WHtR had no significant difference in predicting the incidene of T2DM(P> 0.05). Based on the highest Youden index, the optimal WHtR threshold was 0.49 in young men, 0.50 in middle and old men, 0.47 in young women, and 0.51 in middle and old women. Conclusions WHtR, an easy-to-understand and monitorable indicator, has comparable predictive power to WC and BMI in predicting the incidence of T2DM. It is recommended that Asian individuals should aim for a waist circumference that is half their height