School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia; Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
Nutr Metab Cardiovasc Dis. 2021 Aug 26;31(9):2652-2660. doi: 10.1016/j.numecd.2021.05.028. Epub 2021 Jun 6.
Various obesity indices such as BMI, waist circumference (WC), waist-hip ratio, (WHR) and waist-to-height ratio (WHtR) are associated with the risk of type 2 Diabetes Mellitus (T2DM). Given few studies examining the strength of the association in this population, we aimed to identify which obesity indices are most strongly associated with T2DM and impaired fasting glucose (IFG) among adults from five West African countries.
Data from 15,520 participants from the World Health Organisation (WHO) STEPs surveys in Burkina Faso, Benin, Mali, Liberia, and Ghana were included in analyses. Multinomial logistic regression was used to calculate the relative risk (RR) per standard deviation (SD) of each anthropometric measure, modelled as both continuous variables and as categorical variables based on established cut-points. In the analyses with continuous variables, the unadjusted RRs for T2DM per SD were 1.30 (1.23, 1.37) for body mass index (BMI); 1.56 (1.46, 1.67) for WC; 2.57 (2.15, 3.09) for WHtR and 1.16 (1.03, 1.31) for WHR. WHtR showed the strongest association with T2DM in all adjusted analyses. For models using categorical variables based on established cut-points, obesity defined using waist circumference (OB-WC) and OB-BMI showed the strongest associations with T2DM, and OB-WHR, the weakest association in all adjusted analyses.
WHtR and WC appear to be the indices most strongly associated with T2DM and IFG respectively. Given its simplicity, WC may be the metric that most usefully conveys risk for T2DM in West African adults.
各种肥胖指数，如 BMI、腰围（WC）、腰臀比（WHR）和腰围身高比（WHtR）与 2 型糖尿病（T2DM）的风险相关。鉴于很少有研究检查该人群中关联的强度，我们旨在确定在来自五个西非国家的成年人中，哪些肥胖指数与 T2DM 和空腹血糖受损（IFG）的关联最强。
分析中包括来自布基纳法索、贝宁、马里、利比里亚和加纳的世界卫生组织（WHO） STEPs 调查的 15520 名参与者的数据。使用多变量逻辑回归计算每个人体测量指标的每标准差（SD）的相对风险（RR），分别作为连续变量和基于既定切点的分类变量进行建模。在连续变量的分析中，未经调整的 T2DM 每 SD 的 RR 分别为 BMI 为 1.30（1.23，1.37）；WC 为 1.56（1.46，1.67）；WHtR 为 2.57（2.15，3.09）；WHR 为 1.16（1.03，1.31）。在所有调整后的分析中，WHtR 与 T2DM 的关联最强。对于基于既定切点的分类变量模型，基于腰围的肥胖（OB-WC）和 OB-BMI 与 T2DM 的关联最强，而 OB-WHR 与所有调整后的分析中的关联最弱。
WHtR 和 WC 似乎与 T2DM 和 IFG 分别最密切相关。鉴于其简单性，WC 可能是最有效地传达西非成年人 T2DM 风险的指标。
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