TY - JOUR
T1 - Anthropometric indices and their cut-off points in relation to type 2 diabetes among Ghanaian migrants and non-migrants
T2 - The RODAM study
AU - Darko, Samuel N.
AU - Meeks, Karlijn A.C.
AU - Owiredu, William K.B.A.
AU - Laing, Edwin F.
AU - Boateng, Daniel
AU - Beune, Erik
AU - Addo, Juliet
AU - de-Graft Aikins, Ama
AU - Bahendeka, Silver
AU - Mockenhaupt, Frank
AU - Spranger, Joachim
AU - Agyei-Baffour, Peter
AU - Klipstein-Grobusch, Kerstin
AU - Smeeth, Liam
AU - Agyemang, Charles
AU - Owusu-Dabo, Ellis
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/3
Y1 - 2021/3
N2 - Aims: To compare body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) as determinants of type 2 diabetes (T2DM) and determine optimal cut-offs in a sub-Saharan African population. Methods: Data from the RODAM study including Ghanaians aged 25–70 living in rural Ghana, urban Ghana and Europe were used. Logistic regression was used to assess associations between BMI, WC, WHR and T2DM status, by sex and site. Area under the curve (AUC) were constructed to discriminate between indices and establish performance and cut-off values. Results: WHR had the strongest association with T2DM in men and women across sites, except for rural men. The highest adjusted odds ratio (aOR) and AUC were in rural women for WHR (aOR = 2.09, 95%CI = 1.47–2.99; AUC = 0.71). Among migrants, WHR had higher AUCs compared with BMI (p < 0.01) and WC (p < 0.05). Cut-offs for BMI and WC in men were lower compared with the WHO reference across sites (WC: 85.4–93.7 vs 102 cm, BMI: 23.1–28.2 vs 30.0 kg/m2). Conclusions: WHR outperformed BMI and WC as anthropometric indices in relation to T2DM among Ghanaian migrants. The lower BMI and WC cut-offs for T2DM than WHO established standards, highlights the need for African specific cut-offs to avoid missing high risk populations.
AB - Aims: To compare body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) as determinants of type 2 diabetes (T2DM) and determine optimal cut-offs in a sub-Saharan African population. Methods: Data from the RODAM study including Ghanaians aged 25–70 living in rural Ghana, urban Ghana and Europe were used. Logistic regression was used to assess associations between BMI, WC, WHR and T2DM status, by sex and site. Area under the curve (AUC) were constructed to discriminate between indices and establish performance and cut-off values. Results: WHR had the strongest association with T2DM in men and women across sites, except for rural men. The highest adjusted odds ratio (aOR) and AUC were in rural women for WHR (aOR = 2.09, 95%CI = 1.47–2.99; AUC = 0.71). Among migrants, WHR had higher AUCs compared with BMI (p < 0.01) and WC (p < 0.05). Cut-offs for BMI and WC in men were lower compared with the WHO reference across sites (WC: 85.4–93.7 vs 102 cm, BMI: 23.1–28.2 vs 30.0 kg/m2). Conclusions: WHR outperformed BMI and WC as anthropometric indices in relation to T2DM among Ghanaian migrants. The lower BMI and WC cut-offs for T2DM than WHO established standards, highlights the need for African specific cut-offs to avoid missing high risk populations.
KW - Anthropometrics
KW - Ghanaians
KW - Migrants
KW - RODAM study
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85101065799&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2021.108687
DO - 10.1016/j.diabres.2021.108687
M3 - Article
C2 - 33571601
AN - SCOPUS:85101065799
SN - 0168-8227
VL - 173
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 108687
ER -