WHR may overcome BMI ethnic shortcomings for type 2 diabetes prediction
medwireNews: Researchers report that waist-to-hip ratio (WHR) and waist circumference are associated with type 2 diabetes risk to a similar degree across multiple ethnicities, unlike BMI and body fat.
The team looked at the relationships between the four body composition measures and type 2 diabetes risk in 21,072 participants of the Amsterdam-based Healthy Life in an Urban Setting (HELIUS) study. These comprised 2271 people of Ghanaian origin, 2956 South Asian Surinamese people, 3546 Turkish people, 3850 Moroccans, 3997 African Surinamese, and 4452 people of Dutch origin.
The prevalence of type 2 diabetes varied widely among the ethnicities, being highest in South Asian Surinamese men (23.6%) and women (20.9%) and lowest in Dutch men (5.5%) and women (2.6%).
In both sexes and all ethnicities, WHR was the most accurate predictor of the presence of diabetes, at an overall area under the receiver operating characteristic curve of 0.81 in women and 0.78 in men (where 1.0 represents perfect discrimination between people with and without diabetes).
Fat percentage was the least accurate, at a corresponding 0.72 and 0.66, report Bert-Jan van den Born (University of Amsterdam, the Netherlands) and study co-authors.
Moreover, there was a significant interaction among women in that ethnicity significantly impacted the relationship between BMI and type 2 diabetes risk, and between body fat and diabetes risk. This association was not observed in men, however.
“BMI is a reflection of both muscle and fat mass, whereas body fat percentage is susceptible to differences in the amount of visceral and subcutaneous fat,” write the researchers in Diabetes Care.
They believe the more consistent findings with WHR and waist circumference confirm previous research suggesting that these measures “may be preferred to estimate cardiometabolic risk, especially in multiethnic populations with large differences in body composition.”
Nevertheless, an increase in body fat was significantly associated with an increased risk for type 2 diabetes, irrespective of the anthropometric measure used. This was true for all ethnicities, although the associations were again stronger and with less ethnic variation for WHR and waist circumference than for BMI and body fat.
Despite this variation, the researchers say that, overall, “the association between the different measures of body composition and type 2 diabetes is roughly the same” for all ethnicities.
“These results imply that despite the variations in body build that exist among ethnic groups, the risk of type 2 diabetes is similar,” they add, implying that ethnic differences in overweight and obesity are “likely responsible for most of the discrepancies in type 2 diabetes.”
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