Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana; Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands; Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, United States.
Diabetes Res Clin Pract. 2021 Mar;173:108687. doi: 10.1016/j.diabres.2021.108687. Epub 2021 Feb 8.
To compare body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) as determinants of type 2 diabetes (T2DM) and determine optimal cut-offs in a sub-Saharan African population.
Data from the RODAM study including Ghanaians aged 25-70 living in rural Ghana, urban Ghana and Europe were used. Logistic regression was used to assess associations between BMI, WC, WHR and T2DM status, by sex and site. Area under the curve (AUC) were constructed to discriminate between indices and establish performance and cut-off values.
WHR had the strongest association with T2DM in men and women across sites, except for rural men. The highest adjusted odds ratio (aOR) and AUC were in rural women for WHR (aOR = 2.09, 95%CI = 1.47-2.99; AUC = 0.71). Among migrants, WHR had higher AUCs compared with BMI (p < 0.01) and WC (p < 0.05). Cut-offs for BMI and WC in men were lower compared with the WHO reference across sites (WC: 85.4-93.7 vs 102 cm, BMI: 23.1-28.2 vs 30.0 kg/m).
WHR outperformed BMI and WC as anthropometric indices in relation to T2DM among Ghanaian migrants. The lower BMI and WC cut-offs for T2DM than WHO established standards, highlights the need for African specific cut-offs to avoid missing high risk populations.
比较体重指数（BMI）、腰围（WC）和腰臀比（WHR）作为 2 型糖尿病（T2DM）的决定因素，并确定撒哈拉以南非洲人群的最佳切点。
使用 RODAM 研究的数据，该研究包括居住在加纳农村、加纳城市和欧洲的 25-70 岁的加纳人。采用 logistic 回归分析评估 BMI、WC、WHR 与 T2DM 状态之间的关系，按性别和地点进行分析。构建曲线下面积（AUC）以区分各指数并确定性能和切点值。
除农村男性外，WHR 与各地点男性和女性的 T2DM 相关性最强。在农村女性中，WHR 的调整后比值比（aOR）和 AUC 最高（aOR=2.09，95%CI=1.47-2.99；AUC=0.71）。在移民中，与 BMI 相比，WHR 的 AUC 更高（p<0.01），与 WC 相比 AUC 更高（p<0.05）。各地点男性的 BMI 和 WC 切点值均低于世卫组织参考标准（WC：85.4-93.7 比 102cm，BMI：23.1-28.2 比 30.0kg/m）。
在加纳移民中，与 T2DM 相关，WHR 优于 BMI 和 WC 作为人体测量指数。BMI 和 WC 切点值低于世卫组织制定的标准，这突显了需要制定非洲特有的切点值，以避免漏诊高危人群。
