Zhang F, Wan Q, Cao H, Tang L, Li D, Lü Q, Yan Z, Li J, Yang Q, Zhang Y, Tong N. Identical anthropometric characteristics of
impaired fasting glucose combined with impaired glucose tolerance and newly diagnosed type 2 diabetes: anthropometric indicators to predict hyperglycaemia in a community-based prospective cohort study in southwest China.
BMJ Open 2018;
8:e019735. [PMID:
29743321 PMCID:
PMC5942465 DOI:
10.1136/bmjopen-2017-019735]
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Abstract
OBJECTIVES
To assess the anthropometric characteristics of normoglycaemic individuals who subsequently developed hyperglycaemia, and to evaluate the validity of these measures to predict prediabetes and diabetes.
DESIGN
A community-based prospective cohort study.
PARTICIPANTS
In total, 1885 residents with euglycaemia at baseline from six communities were enrolled.
SETTING
Sichuan, southwest China.
PRIMARY OUTCOME MEASURES
The incidences of prediabetes and diabetes were the primary outcomes.
METHODS
The waist-to-height ratio (WHtR), body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) of all participants were measured at baseline and during follow-up. A 75 g glucose oral glucose tolerance test was conducted at each survey.
RESULTS
During a median of 3.00 (IQR: 2.92-4.17) years follow-up, the cumulative incidence of isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), IFG combined with IGT (IFG+IGT), and newly diagnosed diabetes mellitus (NDDM) were 8.44%, 18.14%, 8.06% and 13.79%, respectively. WHtR, BMI, WC and WHR were significantly different among subjects who subsequently progressed to isolated IFG or IGT, IFG+IGT or NDDM (p<0.05). The anthropometric characteristics of IFG+IGT subjects were similar to those of the NDDM population (p>0.005). All the baseline anthropometric measurements were useful for the prediction of future prediabetes and NDDM (p<0.05). The optimal thresholds for the four measurements were calculated for the prediction of hyperglycaemia, with a WHtR value of 0.52 performing best to identify isolated IFG or IGT, IFG+IGT and NDDM.
CONCLUSIONS
Anthropometric measures, especially WHtR, could be used to predict hyperglycaemia 3 years in advance. Distinct from isolated IFG and IGT, the individuals who developed combined IFG+IGT had identical anthropometric profiles to those who progressed to NDDM.
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