Waist-to-height ratio strongly predicts risk of type 2 diabetes, impaired fasting glucose: Study

"The association was partly mediated by systolic blood pressure (SBP), lipids, HOMA-IR, and other kidney and liver metabolism indicators," Ning Chen from Capital Medical University in Beijing, China, and colleagues wrote in their study.

Diabetes mellitus is a frequent chronic disease that significantly impacts the cardiovascular system. The leading cause of death among diabetes patients is CVD (cardiovascular disease). Diabetes is linked with several major cardiovascular complications, including heart failure, coronary artery disease (angina pectoris and myocardial infarction), peripheral artery disease, and stroke. Early diabetes detection is critical for the prevention of diabetic complications.

Anthropometric measures [i.e., waist-to-hip ratio (WHR), body mass index (BMI), and waist-to-height ratio] have been used as predictive factors for incident hypertension.

Against the above background, the research team conducted the study to evaluate the relationship between waist-to-height ratio and the incidence of impaired fasting glucose/type 2 diabetes. The team also explored how lipids, blood pressure, and other kidney and liver metabolism indicators mediate these associations.

The research was based on a functional community cohort that comprised 6109 participants; they were divided into two sub-cohorts. One sub-cohort included 5563 participants with normal fasting glucose, and the second had 546 IFG individuals at baseline. The relationships of WHtR were evaluated with type 2 diabetes/impaired fasting glucose using Cox regression models. To determine the discriminatory power of WhtR and other anthropometric indices on type 2 diabetes, the authors calculated the area under curve (AUC) and four-year time-dependent receiver operating characteristic (ROC) curve.

The study led to the following findings:

• Both sub-cohort found significant positive associations between WHtR and the incidence of T2D/IFG.
• The waist-to-height ratio was a valuable predictor of T2D.
• Mediation analysis revealed that SBP (5.10 %), HOMA-IR (0.45 %), creatinine (9.36 %), triglycerides (11.02 %), and combined kidney indicators (17.48 %) partly mediated the WHtRs effect on type 2 diabetes in men.
• For women, this association was partly mediated by HDL (24.54 %), SBP (13.86 %), ALT (6.29 %), UA (22.58 %) and combined kidney indicators (39.51 %).

The study showed strong correlations between waist-to-height ratio and type 2 diabetes/impaired fasting glucose.

"WHtR is an independent risk factor for type 2 diabetes and impaired fasting glucose development," the researchers concluded. "SBP, lipids, HOMA-IR, and other kidney and liver metabolism indicators partly mediated this association."

Reference:

Chen, N., Hu, L., Sun, Y., Dong, J., Chu, X., Lu, Y., Liu, Y., Ma, L., & Yan, Y. (2022). Associations of waist-to-height ratio with the incidence of type 2 diabetes and mediation analysis: Two independent cohort studies. Obesity Research & Clinical Practice. https://doi.org/10.1016/j.orcp.2022.12.005