Best anthropometric discriminators of incident type 2 diabetes among white and black adults: A longitudinal ARIC study

Dale S. Hardy, Devita T. Stallings, Jane T. Garvin, Hongyan Xu, Susan B. Racette

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To determine which anthropometric measures are the strongest discriminators of incident type 2 diabetes (T2DM) among White and Black males and females in a large U.S. cohort. Methods: We used Atherosclerosis Risk in Communities study data from 12,121 participants aged 45±64 years without diabetes at baseline who were followed for over 11 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and waist to hip to height ratio (WHHR). All anthropometric measures were repeated at each visit and converted to Z-scores. Hazard ratios and 95% confidence intervals adjusted for age were calculated using repeated measures Cox proportional hazard regression analysis. Akaike Information Criteria was used to select best-fit models. The magnitude of the hazard ratio effect sizes and the Harrell's C-indexes were used to rank the highest associations and discriminators, respectively. Results: There were 1,359 incident diabetes cases. Higher values of all anthropometric measures increased the risk for development of T2DM (p < 0.0001) except ABSI, which was not significant in White and Black males. Statistically significant hazard ratios ranged from 1.26±1.63 for males and 1.15±1.88 for females. In general, the largest hazard ratios were those that corresponded to the highest Harrell's C-Index and lowest Akaike Information Criteria values. Among White and Black males and females, BMI, WC, WHR, and WHtR were comparable in discriminating cases from non-cases of T2DM. ABSI, BAI, and WHHR were inferior discriminators of incident T2DM across all race-gender groups. Conclusions: BMI, the most commonly used anthropometric measure, and three anthropometric measures that included waist circumference (i.e., WC, WHR, WHtR) were the best anthropometric discriminators of incident T2DM across all race-gender groups in the ARIC cohort.

Original languageEnglish (US)
Article numbere0168282
JournalPloS one
Volume12
Issue number1
DOIs
StatePublished - Jan 2017

Fingerprint

Discriminators
waist circumference
Waist Circumference
Medical problems
longitudinal studies
noninsulin-dependent diabetes mellitus
waist-to-hip ratio
Type 2 Diabetes Mellitus
Waist-Hip Ratio
Longitudinal Studies
Hazards
anthropometric measurements
body mass index
Body Mass Index
waist
Adiposity
adiposity
hips
diabetes
Hip

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Best anthropometric discriminators of incident type 2 diabetes among white and black adults : A longitudinal ARIC study. / Hardy, Dale S.; Stallings, Devita T.; Garvin, Jane T.; Xu, Hongyan; Racette, Susan B.

In: PloS one, Vol. 12, No. 1, e0168282, 01.2017.

Research output: Contribution to journalArticle

Hardy, Dale S. ; Stallings, Devita T. ; Garvin, Jane T. ; Xu, Hongyan ; Racette, Susan B. / Best anthropometric discriminators of incident type 2 diabetes among white and black adults : A longitudinal ARIC study. In: PloS one. 2017 ; Vol. 12, No. 1.
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abstract = "Objective: To determine which anthropometric measures are the strongest discriminators of incident type 2 diabetes (T2DM) among White and Black males and females in a large U.S. cohort. Methods: We used Atherosclerosis Risk in Communities study data from 12,121 participants aged 45±64 years without diabetes at baseline who were followed for over 11 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and waist to hip to height ratio (WHHR). All anthropometric measures were repeated at each visit and converted to Z-scores. Hazard ratios and 95{\%} confidence intervals adjusted for age were calculated using repeated measures Cox proportional hazard regression analysis. Akaike Information Criteria was used to select best-fit models. The magnitude of the hazard ratio effect sizes and the Harrell's C-indexes were used to rank the highest associations and discriminators, respectively. Results: There were 1,359 incident diabetes cases. Higher values of all anthropometric measures increased the risk for development of T2DM (p < 0.0001) except ABSI, which was not significant in White and Black males. Statistically significant hazard ratios ranged from 1.26±1.63 for males and 1.15±1.88 for females. In general, the largest hazard ratios were those that corresponded to the highest Harrell's C-Index and lowest Akaike Information Criteria values. Among White and Black males and females, BMI, WC, WHR, and WHtR were comparable in discriminating cases from non-cases of T2DM. ABSI, BAI, and WHHR were inferior discriminators of incident T2DM across all race-gender groups. Conclusions: BMI, the most commonly used anthropometric measure, and three anthropometric measures that included waist circumference (i.e., WC, WHR, WHtR) were the best anthropometric discriminators of incident T2DM across all race-gender groups in the ARIC cohort.",
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