Anthropometric discriminators of type 2 diabetes among White and Black American adults

Background: The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample. Methods: We used Atherosclerosis Risk in Communities study baseline data (1987–89) from 15 242 participants (1827 with T2DM) aged 45–65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist: height ratio (WHtR), and waist: hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models. Results: Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race–gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults. Conclusions: Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race–gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females.