Central rather than overall obesity is related to diabetes in the Chinese population: The InterASIA study

Objective: The objective was to compare central and overall obesity measurements for identifying diabetes mellitus (DM) and impaired fasting glucose (IFG) level in the Chinese population. Research Methods and Procedures: Data for 15,236 Chinese adults between the ages of 35 and 74 years, obtained by the InterASIA Study in 2000-2001, were used for the current analyses. We analyzed the areas under the receiver operating characteristic (ROC) curves (AUCs) for waist circumference (WC), waist-to-hip ratio (WHR), and BMI to determine the ability of these indices to identify DM and IFG in the study sample and bootstrapped samples. WC was used as a measure of central obesity and BMI as a measure of overall obesity. Results: The prevalence rates of central and overall obesity in the study population were 33.97% and 9.78%, respectively. The prevalence rates of IFG and DM were 7.34% and 5.51%, respectively. ROC analysis revealed significant differences between AUCs for WHR (0.666, 95% confidence interval, 0.647 to 0.685) and BMI (0.622, 95% confidence interval, 0.601 to 0.642) and for WC (0.661, 95% confidence interval, 0.643 to 0.682) and BMI for identifying DM (all p < 0.0001). The analysis also revealed significant differences between AUCs for WHR (0.638, 95% confidence interval, 0.619 to 0.655) and BMI (0.607, 95% confidence interval, 0.589 to 0.627) and for WC (0.637, 95% confidence interval, 0.615 to 0.654) and BMI for identifying IFG (all p < 0.001). Discussion: Central obesity is more related to DM and IFG than is overall obesity in the Chinese population, and both WC and WHR are equally able to identify DM.