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 May 9;8(5):e019735. doi: 10.1136/bmjopen-2017-019735.

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.

Keywords: anthropometric measurements; impaired fasting glucose combined with impaired glucose tolerance; newly-diagnosed diabetes mellitus; pre-diabetes; waist-to-height ratio.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anthropometry / methods*
  • Blood Glucose*
  • China / epidemiology
  • Cohort Studies
  • Comorbidity
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Fasting
  • Female
  • Follow-Up Studies
  • Glucose Intolerance / blood
  • Glucose Intolerance / epidemiology*
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / epidemiology*
  • Incidence
  • Male
  • Middle Aged
  • Prediabetic State / blood
  • Prediabetic State / epidemiology
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results

Substances

  • Blood Glucose