Waist Circumference, Relative Fat Mass Index, and BMI as Classifiers of Diabetes Status: A Comparative, Cross-sectional Analysis in 82 Low- and Middle-Income Countries.
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Seiglie Jacqueline A, Seuring Till, Teufel Felix, Marcus Maja E, Theilmann Michaela, Geldsetzer Pascal, Agoudavi Kokou, Andall-Brereton Glennis, Aryal Krishna K, Wilfried Bicaba Brice, Bovet Pascal, Campos Caldeira Brant Luisa, Brian Garry, Damasceno Albertino, Dorobantu Maria, Farzadfar Farshad, Gathecha Gladwell, Golestani Ali, Singh Gurung Mongal, Heidari-Foroozan Mahsa, Houehanou Corine, Houinato Dismand, Hwalla Nahla, Jorgensen Jutta, Mwangi Kibachio J, Kagaruki Gibson B, Karki Khem B, Lunet Nuno, Malta Deborah C, Martins Joao S, Msaidie Mohammed, Mwalim Omar, Norov Bolormaa, Quesnel-Crooks Sarah, Saeedi Moghaddam Sahar, Sibai Abla, Sturua Lela, Tsabedze Lindiwe, Stanford Wesseh Chea, Wong McClure Roy, Gune Yoo Sang, Atun Rifat, Davies Justine I, Vollmer Sebastian, Bärnighausen Till W, Flood David, Woolcott Orison O, Manne-Goehler Jennifer
Аннотация
RESEARCH DESIGN AND METHODS: Individual-level data were analyzed from nationally representative surveys across 82 LMICs, comprising 598,883 adults aged ≥25 years with a BMI of 18.5-29.9 kg/m2. Associations of anthropometric measures with diabetes were estimated as risk ratios using Poisson regression and area under the curve (AUC), stratified by sex and geographic region.
RESULTS: Pooled diabetes prevalence was 9.1% (95% CI 8.51-9.68). Overall, risk of diabetes was greatest for WC and RFM at the highest quintile, compared with BMI. The AUC for WC and RFM as a classifier of diabetes status was higher than the AUC for BMI in men (AUC: WC 0.69, RFM 0.69, BMI 0.64) and women (AUC: WC 0.69, RFM 0.69, BMI 0.63). Generally, the AUC for RFM was higher than the AUC for BMI and either higher than or equal to WC across regions and sex.
CONCLUSIONS: WC and RFM outperformed BMI as classifiers of diabetes status among adults with a BMI of 18.5-29.9 kg/m2 across 82 LMICs. Inclusion of WC-based measures in diabetes screening guidelines could improve timely diabetes detection and resource allocation in LMICs among individuals at intermediate BMI ranges.