Abstract: Objective To explore whether the increase of body mass index(BMI),waist circum ference(WC),waist to hip ratio(WHR),and waist to height ratio(WHRt) can predict the risk of developing type 2 diabetes mellitus(T2DM).Methods A population based cross sectional study was conducted among local residents above 35 years in three urban districts and one rural county in July 2004.The subjects who were non T2DM in the base line survey were selected for a follow up survey in July 2007.Multiva riate logistic regression analyisis and area under curve(AUC) of receiver operating characteristics(ROC) were used to evaluate the predictive value of BM,IWC,WHR and WHtR.Results Of 4058 subjects with out T2DM in ba seline survey,3031 partic ipated the follow up survey with a follow up rate of 74.7%.The three year cumulative incidence of diabetes was 2.4%.The risk of developing T2DM increased a long with BMI,WC,WHR,and WHtR.Among the fourindices,higher WC and WHRt ≧0.5 had a higher risk of developing T2DM.Data from ROC curve analysis showed that the AU Cof WHtR was the highest.Conclusion The increase of BMI,WC,W HR and WHRt could predict the higher risk of the development of T2DM.WHtR might be a smiple and most effective index of T2DM.