Department of Public Health, University of Helsinki, Helsinki, Finland.
Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland.
BMJ Open. 2018 May 17;8(5):e019166. doi: 10.1136/bmjopen-2017-019166.
To compare the performance of body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC) and waist-to-hip ratio (WHR) in detecting type 2 diabetes among Russian, Somali and Kurdish (born in Iraq/Iran) origin migrants and Finns.
Cross-sectional study comparing health examination survey data of Russian, Somali and Kurdish origin migrants (n=917) aged 30-64 years who took part in the Migrant Health and Wellbeing Survey with the general Finnish population in the Health 2011 Survey (n=887). Participants were randomly selected from the National Population Register.
Six cities in Finland, where a substantial majority of migrants live.
Anthropometric measures included objectively measured BMI, WHtR, WC and WHR. Type 2 diabetes was defined based on self-report, laboratory measures of glycated haemoglobin and register data. Test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy.
Among Finns, test performance was highest for WC (AUC=0.81, 95% CI 0.74 to 0.87) and WHtR (AUC=0.81, 95% CI 0.75 to 0.87). Test performance was similar for BMI (AUC=0.80, 95% CI 0.67 to 0.92), WC (AUC=0.79, 95% CI 0.67 to 0.91) and WHtR (AUC=0.70, 95% CI 0.66 to 0.93) among Russians. WC and WHtR had highest test performance also among Somali (AUC=0.74, 95% CI 0.64 to 0.84 for WC and AUC=0.75, 95% CI 0.65 to 0.85 for WHtR) and Kurds (AUC=0.71, 95% CI 0.61 to 0.81 for WC and AUC=0.70, 95% CI 0.59 to 0.80 for WHtR).Among migrants, WHR had the poorest test performance.
WC and WHtR performed overall the best across all study groups, however, accuracy of detection was lower particularly among Somali and Kurds. Currently used diabetes risk assessment tools assume a strong association between anthropometrics and diabetes. These tools need to be validated among non-Western populations.
比较体质指数（BMI）、腰高比（WHtR）、腰围（WC）和腰臀比（WHR）在俄罗斯、索马里和库尔德（生于伊拉克/伊朗）移民以及芬兰人中间检测 2 型糖尿病的性能。
横断面研究比较了参加移民健康和幸福感调查的 30-64 岁俄罗斯、索马里和库尔德原籍移民（n=917）的健康检查调查数据与芬兰一般人群 2011 年健康调查（n=887）的数据。参与者是从国家人口登记册中随机选择的。
芬兰六个城市，大多数移民居住在那里。
包括 BMI、WHtR、WC 和 WHR 在内的人体测量指标是客观测量的。2 型糖尿病是根据自我报告、糖化血红蛋白的实验室测量和登记数据来定义的。使用接收者操作特征曲线评估测试性能，使用曲线下面积（AUC）作为准确性的衡量标准。
在芬兰人中，WC（AUC=0.81，95%置信区间 0.74 至 0.87）和 WHtR（AUC=0.81，95%置信区间 0.75 至 0.87）的测试性能最高。BMI（AUC=0.80，95%置信区间 0.67 至 0.92）、WC（AUC=0.79，95%置信区间 0.67 至 0.91）和 WHtR（AUC=0.70，95%置信区间 0.66 至 0.93）在俄罗斯人中的测试性能也相似。WC 和 WHtR 在索马里人（WC 的 AUC=0.74，95%置信区间 0.64 至 0.84；WHtR 的 AUC=0.75，95%置信区间 0.65 至 0.85）和库尔德人（WC 的 AUC=0.71，95%置信区间 0.61 至 0.81；WHtR 的 AUC=0.70，95%置信区间 0.59 至 0.80）中也具有最高的测试性能。在移民中，WHR 的测试性能最差。
WC 和 WHtR 在所有研究组中总体表现最佳，然而，特别是在索马里和库尔德人中，检测的准确性较低。目前用于评估糖尿病风险的工具假设人体测量指标与糖尿病之间存在很强的关联。这些工具需要在非西方人群中进行验证。
