Comparison and assessment of anthropometric index with risk of type 2 diabetes mellitus: two prospective cohort studies in China.

AIM: Obesity is a well-established risk factor for type 2 diabetes mellitus (T2DM), with specific anthropometric indices offering even greater predictive value. This study aimed to systematically examine the associations between 17 anthropometric indices and T2DM risk, as well as the predictive value of these indices for T2DM.

METHODS

Data from the Shanghai Men's and Women's Health Studies were used. Cox regression models estimated hazard ratios (HRs). Receiver operating characteristic (ROC) curves assessed the predictive performance, with subgroup and sensitivity analyses conducted to evaluate robustness.

RESULTS

The study included 71 356 women and 56 288 men, with a mean follow-up of 17.42 and 12.35 years, respectively. Relative fat mass (RFM) had the highest HR in women (HR per SD = 2.42, 95% CI: 2.34-2.49) and men (HR per SD = 2.22, 95% CI: 2.13-2.31). Abdominal adiposity indices (e.g., WC, waist-to-height ratio [WHtR], body roundness index [BRI]) outperformed general adiposity indices (e.g., BMI) in predicting T2DM risk.

CONCLUSIONS

Abdominal adiposity indices have significant value in predicting T2DM risk, with notable sex-specific differences. Among these, RFM were better predictors in both women and men. These findings suggest that abdominal obesity indices could be used to inform prevention strategies.