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Optimal cut-points of different anthropometric indices and their joint effect in prediction of type 2 diabetes: results of a cohort study

Zafari, N, Lotfaliany, Mojtaba, Mansournia, MA, Khalili, D, Azizi, F and Hadaegh, F 2018, Optimal cut-points of different anthropometric indices and their joint effect in prediction of type 2 diabetes: results of a cohort study, BMC public health, vol. 18, no. 1, pp. 1-12, doi: 10.1186/s12889-018-5611-6.

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Title Optimal cut-points of different anthropometric indices and their joint effect in prediction of type 2 diabetes: results of a cohort study
Author(s) Zafari, N
Lotfaliany, MojtabaORCID iD for Lotfaliany, Mojtaba orcid.org/0000-0001-6594-9004
Mansournia, MA
Khalili, D
Azizi, F
Hadaegh, F
Journal name BMC public health
Volume number 18
Issue number 1
Article ID 691
Start page 1
End page 12
Total pages 12
Publisher BMC
Place of publication London, Eng.
Publication date 2018
ISSN 1471-2458
Keyword(s) BMI
Waist circumference
Waist to height ratio
Obesity
Cohort study
Joint effect
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
BODY-MASS INDEX
CORONARY-HEART-DISEASE
TO-HEIGHT RATIO
HIP CIRCUMFERENCE
ABDOMINAL OBESITY
FAT DISTRIBUTION
RISK-FACTORS
OPTIMAL CUTPOINTS
MEN
Summary Background: To determine the anthropometric indices that would predict type 2 diabetes (T2D) and delineate their optimal cut-points. Methods: In a cohort study, 7017 Iranian adults, aged 20–60 years, free of T2D at baseline were investigated. Using Cox proportional hazard models, hazard ratios (HRs) for incident T2D per 1 SD change in body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), and hip circumference (HC) were calculated. The area under the receiver operating characteristics (ROC) curves (AUC) was calculated to compare the discriminative power of anthropometric variables for incident T2D. Cut-points of each index were estimated by the maximum value of Youden’s index and fixing the sensitivity at 75%. Using the derived cut-points, joint effects of BMI and other obesity indices on T2D hazard were assessed. Results: During a median follow-up of 12 years, 354 men, and 490 women developed T2D. In both sexes, 1 SD increase in anthropometric variables showed significant association with incident T2D, except for HC in multivariate adjusted model in men. In both sexes, WHtR had the highest discriminatory power while HC had the lowest. The derived cut-points for BMI, WC, WHtR, WHR, and HC were 25.56 kg/m2, 89 cm, 0.52, 0.91, and 96 cm in men and 27.12 kg/m2, 87 cm, 0.56, 0.83, and 103 cm in women, respectively. Assessing joint effects of BMI and each of the obesity measures in the prediction of incident T2D showed that among both sexes, combined high values of obesity indices increase the specificity for the price of reduced sensitivity and positive predictive value. Conclusions: Our derived cut-points differ between both sexes and are different from other ethnicities.
Language eng
DOI 10.1186/s12889-018-5611-6
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30144091

Document type: Journal Article
Collections: Faculty of Health
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.