Distribution of obesity related anthropometric indicators and optimal cut points for screening diabetes mellitus in Chinese adults

Objective To explore distributions and optimal cut points of obesity related anthropometric indicators for screening diabetes mellitus (DM) among Chinese adults and to provide evidences for the prevention and control of DM.Methods Using multi-stage stratified randomized sampling,8 824 Chinese adult permanent residents (≥18 years old) were selected from nine provinces (Heilongjiang,Liaoning,Henan,Shandong,Jiangsu,Hubei,Hunan,Guangxi,and Guizhou province) and surveyed with physical examination and fasting blood glucose (FBG) measurement between September and December 2009.The receiver operating characteristic curve (ROC) was used to study the value of obesity related anthropometric indicators for DM screening and the appropriate cut points were determined based on Youden index.Results Of the 8 824 subjects,673 DM cases were identified,with an overall prevalence rate of 7.63% and a significantly higher prevalence rate among the males than among the females (8.85% vs.6.50%,χ²=17.04;P<0.001).There were significant between-age differences in obesity related anthropometric indicators among both male and female participants (P<0.001).Among the male participants,the waist circumference (WC) was the most suitable obesity related anthropometric indicator for DM screening,with the area under the curve (AUC) values of greater than 0.70 for all various age groups and the optimal cut points of 88.1,84.15,86.9,and 87.5 centimeters for the participants aged 18-34,35-54,55-74,and ≥75 years.While among the female participants,the appropriate obesity related anthropometric indicator for DM screening varied for different age groups;waist-to-hip ratio (WHpR),waist to height ratio (WHtR) and body mass index (BMI) were the most appropriate obesity related anthropometric indicators for DM screening for the participants aged 18-34,35-54,and ≥55 years,with all the AUC values of greater than 0.67;the optimal cut points of the DM screening indicators for the female participants aged 18-34,35-54,55-74,and ≥75 years were 0.824 (WHpR),0.528 (WHtR),23.110 kg/m² (BMI),and 21.432 kg/m² (BMI),respectively.Conclusion Waist circumference is an appropriate indicator for DM screening in Chinese adult men,while waist-to-hip ratio,waist to height ratio and body mass index are suitable indicators for DM screening for Chinese women aged 18-34,35-54,and ≥55 years,respectively.