Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados
Introduction Body mass index (BMI) and waist circumference (WC) cut-offs associated with hyperglycemia may differ by ethnicity. We investigated the optimal BMI and WC cut-offs for identifying hyperglycemia in the predominantly Afro-Caribbean population of Barbados.Research design and methods A cross...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/9/1/e002246.full |
| _version_ | 1819034792866349056 |
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| author | Nigel Unwin Angela M C Rose Ian R Hambleton Christina Howitt Anselm J M Hennis Selvi M Jeyaseelan Nkemcho O Ojeh |
| author_facet | Nigel Unwin Angela M C Rose Ian R Hambleton Christina Howitt Anselm J M Hennis Selvi M Jeyaseelan Nkemcho O Ojeh |
| author_sort | Nigel Unwin |
| collection | DOAJ |
| description | Introduction Body mass index (BMI) and waist circumference (WC) cut-offs associated with hyperglycemia may differ by ethnicity. We investigated the optimal BMI and WC cut-offs for identifying hyperglycemia in the predominantly Afro-Caribbean population of Barbados.Research design and methods A cross-sectional study of 865 individuals aged ≥25 years without known diabetes or cardiovascular disease was conducted. Hyperglycemia was defined as fasting plasma glucose ≥5.6 mmol/L or hemoglobin A1c ≥5.7% (39 mmol/mol). The Youden index was used to identify the optimal cut-offs from the receiver operating characteristic (ROC) curves. Further ROC analysis and multivariable log binomial regression were used to compare standard and data-derived cut-offs.Results The prevalence of hyperglycemia was 58.9% (95% CI 54.7% to 63.0%). In women, optimal BMI and WC cut-offs (27 kg/m2 and 87 cm, respectively) performed similarly to standard cut-offs. In men, sensitivities of the optimal cut-offs of BMI ≥24 kg/m2 (72.0%) and WC ≥86 cm (74.0%) were higher than those for standard BMI and WC obesity cut-offs (30.0% and 25%–46%, respectively), although with lower specificity. Hyperglycemia was 70% higher in men above the data-derived WC cut-off (prevalence ratio 95% CI 1.2 to 2.3).Conclusions While BMI and WC cut-offs in Afro-Caribbean women approximate international standards, our findings, consistent with other studies, suggest lowering cut-offs in men may be warranted to improve detection of hyperglycemia. Our findings do, however, require replication in a new data set. |
| first_indexed | 2024-12-21T07:39:22Z |
| format | Article |
| id | doaj.art-4876635d8ac94500ba5d0382828dad7e |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-12-21T07:39:22Z |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-4876635d8ac94500ba5d0382828dad7e2022-12-21T19:11:21ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-10-019110.1136/bmjdrc-2021-002246Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from BarbadosNigel Unwin0Angela M C Rose1Ian R Hambleton2Christina Howitt3Anselm J M Hennis4Selvi M Jeyaseelan5Nkemcho O Ojeh61 Health and Society, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK2 The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados1Chronic Disease Research Centre, Tropical Medicine Research Institute, The University of the West Indies, Bridgetown, Barbados1Chronic Disease Research Centre, Tropical Medicine Research Institute, The University of the West Indies, Bridgetown, BarbadosThe University of the West Indies George Alleyne Chronic Disease Research Centre, Bridgetown, BarbadosFaculty of Medical Sciences, The University of the West Indies Cave Hill Campus, Bridgetown, BarbadosFaculty of Medical Sciences, The University of the West Indies Cave Hill Campus, Bridgetown, BarbadosIntroduction Body mass index (BMI) and waist circumference (WC) cut-offs associated with hyperglycemia may differ by ethnicity. We investigated the optimal BMI and WC cut-offs for identifying hyperglycemia in the predominantly Afro-Caribbean population of Barbados.Research design and methods A cross-sectional study of 865 individuals aged ≥25 years without known diabetes or cardiovascular disease was conducted. Hyperglycemia was defined as fasting plasma glucose ≥5.6 mmol/L or hemoglobin A1c ≥5.7% (39 mmol/mol). The Youden index was used to identify the optimal cut-offs from the receiver operating characteristic (ROC) curves. Further ROC analysis and multivariable log binomial regression were used to compare standard and data-derived cut-offs.Results The prevalence of hyperglycemia was 58.9% (95% CI 54.7% to 63.0%). In women, optimal BMI and WC cut-offs (27 kg/m2 and 87 cm, respectively) performed similarly to standard cut-offs. In men, sensitivities of the optimal cut-offs of BMI ≥24 kg/m2 (72.0%) and WC ≥86 cm (74.0%) were higher than those for standard BMI and WC obesity cut-offs (30.0% and 25%–46%, respectively), although with lower specificity. Hyperglycemia was 70% higher in men above the data-derived WC cut-off (prevalence ratio 95% CI 1.2 to 2.3).Conclusions While BMI and WC cut-offs in Afro-Caribbean women approximate international standards, our findings, consistent with other studies, suggest lowering cut-offs in men may be warranted to improve detection of hyperglycemia. Our findings do, however, require replication in a new data set.https://drc.bmj.com/content/9/1/e002246.full |
| spellingShingle | Nigel Unwin Angela M C Rose Ian R Hambleton Christina Howitt Anselm J M Hennis Selvi M Jeyaseelan Nkemcho O Ojeh Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados BMJ Open Diabetes Research & Care |
| title | Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados |
| title_full | Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados |
| title_fullStr | Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados |
| title_full_unstemmed | Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados |
| title_short | Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados |
| title_sort | anthropometric cut offs to identify hyperglycemia in an afro caribbean population a cross sectional population based study from barbados |
| url | https://drc.bmj.com/content/9/1/e002246.full |
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