Accuracy of Anthropometric Indexes of Obesity to Predict Diabetes Mellitus Type 2 Among Men and Women With Hypertension

• Published in: American journal of hypertension Vol. 24; no. 2; pp. 175 - 180
• Main Authors: Marcadenti, Aline, Fuchs, Sandra C., Moreira, Leila B., Wiehe, Mario, Gus, Miguel, Fuchs, Flavio D.
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01.02.2011; Nature Publishing Group
• Subjects: Aged; Anthropometry; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - analysis; Blood Pressure; Body Mass Index; Brazil - epidemiology; Cardiology. Vascular system; Chi-Square Distribution; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - physiopathology; Hypoglycemic Agents - therapeutic use; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - diagnosis; Obesity - epidemiology; Predictive Value of Tests; Regression Analysis; Risk Assessment; Risk Factors; ROC Curve; Sensitivity and Specificity; Sex Factors; Waist Circumference; Waist-Hip Ratio; Brazil; blood pressure; anthropometric indexes; central obesity; diagnosis; diabetes mellitus; sensitivity; hypertension; obesity; Endocrinopathy; Type 2 diabetes; Human; Hypertension; Obesity; Nutrition disorder; Metabolic diseases; Cardiovascular disease; Arterial pressure; Blood pressure; Diagnosis; Nutritional status
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2010.212

Background Anthropometric measurements and indexes that assess excess of adiposity are associated with cardiovascular risk factors, and predict diabetes mellitus. Methods This cross-sectional study reported the performance of adiposity indexes to detect or turn diabetes unlikely in patients with hypertension. Patients with hypertension (blood pressure (BP)≥140/90 mm Hg or antihypertensive drug use) aged 18-80 years, being 150 men and 332 women, had weight, height, waist circumference (WC), hip circumference, body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), and waist-tosquare height ratio (WHt2R) calculated. Diabetes was diagnosed by fasting blood glucose ≥126 mg/dl or antidiabetic drug use (23% of the sample). Results All anthropometric indexes were associated with diabetes in a modified Poisson regression, adjusting for age, smoking, and physical activity, in women, but not in men. In men, only the area under the receiver-operating characteristic curve (AUC) for WHR was statistically associated with diabetes (0.67, 95% confidence interval (CI) 0.57-0.77). A cutoff of ≥0.95 had sensitivity of 84.6% (73.3-95.9) and negative post-test probability of 12.8% (3.2-22.4). Among women, WC >88 cm, WHR ≥0.85, and WHtR > 0.54 had sensitivity >93% and negative post-test probability <7.5%. Conclusions WHR ≥0.85, WC >88.0 cm, and WHtR >0.54 for women and WHR ≥0.95 for men are highly suggestive of diabetes among this population of hypertensive patients. Indexes below these cutoffs turn diabetes unlikely in this context. The investigation of reproducibility of this performance in other outpatient clinics is warranted. American Journal of Hypertension, advance online publication 30 September 2010; doi:10.1038/ajh.2010.212