Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study
Background: Type 2 diabetes (T2D) is one of the top non-communicable diseases in Kenya and prevention strategies are urgently needed. Intervening to reduce obesity is the most common prevention strategy. However, black populations develop T2D at lower obesity levels and it is unclear which anthropo...
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| Format: | Article |
| Language: | English |
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AIMS Press
2021-07-01
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| Series: | AIMS Public Health |
| Subjects: | |
| Online Access: | https://www.aimspress.com/article/doi/10.3934/publichealth.2021041?viewType=HTML |
| _version_ | 1818584898452062208 |
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| author | Anthony Muchai Manyara |
| author_facet | Anthony Muchai Manyara |
| author_sort | Anthony Muchai Manyara |
| collection | DOAJ |
| description | Background:
Type 2 diabetes (T2D) is one of the top non-communicable diseases in Kenya and prevention strategies are urgently needed. Intervening to reduce obesity is the most common prevention strategy. However, black populations develop T2D at lower obesity levels and it is unclear which anthropometric cut-offs could provide the best predictive ability for T2D risk. This study, therefore, aimed to determine the optimal anthropometric cut-offs and their predictive ability of T2D in Kenya.
Methods:
The study included 2159 participants (59% women) aged 35–70 years from the Kenya STEPwise survey conducted in 2014. Five anthropometric indices were used—body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR) and waist divided by height0.5(WHt.5R). Diabetes was defined as a fasting blood glucose of ≥7.0 mmol/l or a previous diagnosis by a health worker. Optimal anthropometric cut-offs and their receiver operating characteristics, such as the area under the curve (AUC), were computed.
Results:
Overall, the optimal cut-off for BMI, WC, WHR, WHtR and WHt.5R were 24.8 kg.m−2, 90 cm, 0.88, 0.54 and 6.9. On disaggregation by sex, the optimal cut-off for BMI, WC, WHR WHtR and WHt.5R was 27.1 kg.m−2, 87 cm, 0.85, 0.55 and 6.9 in women, and 24.8 kg.m−2, 91 cm, 0.88, 0.54 and 6.9 in men. Overall, WC (AUC 0.71 (95% confidence interval 0.65, 0.76)) WHtR (AUC 0.71 (0.66, 0.76)) and WHt.5R (AUC 0.70 (0.65,0.75)) had a better predictive ability for T2D than BMI (AUC 0.68 (0.62, 0.73)).
Conclusions:
WC, WHtR and WHt.5R were better predictors of T2D than BMI and should be used for risk stratification in Kenya. A WC cut-off of 87cm in women and 91cm in men, a WHtR cut-off of 0.54 or a WHt.5R of 6.9 in both men and women should be used to identify individuals at an elevated risk of T2D. |
| first_indexed | 2024-12-16T08:28:29Z |
| format | Article |
| id | doaj.art-f812250af0844f859d0c3f33693dbca7 |
| institution | Directory Open Access Journal |
| issn | 2327-8994 |
| language | English |
| last_indexed | 2024-12-16T08:28:29Z |
| publishDate | 2021-07-01 |
| publisher | AIMS Press |
| record_format | Article |
| series | AIMS Public Health |
| spelling | doaj.art-f812250af0844f859d0c3f33693dbca72022-12-21T22:37:56ZengAIMS PressAIMS Public Health2327-89942021-07-018350751810.3934/publichealth.2021041Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan studyAnthony Muchai Manyara0Social and Political Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UKBackground: Type 2 diabetes (T2D) is one of the top non-communicable diseases in Kenya and prevention strategies are urgently needed. Intervening to reduce obesity is the most common prevention strategy. However, black populations develop T2D at lower obesity levels and it is unclear which anthropometric cut-offs could provide the best predictive ability for T2D risk. This study, therefore, aimed to determine the optimal anthropometric cut-offs and their predictive ability of T2D in Kenya. Methods: The study included 2159 participants (59% women) aged 35–70 years from the Kenya STEPwise survey conducted in 2014. Five anthropometric indices were used—body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR) and waist divided by height0.5(WHt.5R). Diabetes was defined as a fasting blood glucose of ≥7.0 mmol/l or a previous diagnosis by a health worker. Optimal anthropometric cut-offs and their receiver operating characteristics, such as the area under the curve (AUC), were computed. Results: Overall, the optimal cut-off for BMI, WC, WHR, WHtR and WHt.5R were 24.8 kg.m−2, 90 cm, 0.88, 0.54 and 6.9. On disaggregation by sex, the optimal cut-off for BMI, WC, WHR WHtR and WHt.5R was 27.1 kg.m−2, 87 cm, 0.85, 0.55 and 6.9 in women, and 24.8 kg.m−2, 91 cm, 0.88, 0.54 and 6.9 in men. Overall, WC (AUC 0.71 (95% confidence interval 0.65, 0.76)) WHtR (AUC 0.71 (0.66, 0.76)) and WHt.5R (AUC 0.70 (0.65,0.75)) had a better predictive ability for T2D than BMI (AUC 0.68 (0.62, 0.73)). Conclusions: WC, WHtR and WHt.5R were better predictors of T2D than BMI and should be used for risk stratification in Kenya. A WC cut-off of 87cm in women and 91cm in men, a WHtR cut-off of 0.54 or a WHt.5R of 6.9 in both men and women should be used to identify individuals at an elevated risk of T2D.https://www.aimspress.com/article/doi/10.3934/publichealth.2021041?viewType=HTMLdiabetespredictionanthropometric cut-offskenyaafricawaist circumferencewaist-to-height ratio |
| spellingShingle | Anthony Muchai Manyara Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study AIMS Public Health diabetes prediction anthropometric cut-offs kenya africa waist circumference waist-to-height ratio |
| title | Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study |
| title_full | Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study |
| title_fullStr | Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study |
| title_full_unstemmed | Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study |
| title_short | Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study |
| title_sort | optimal cut offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative kenyan study |
| topic | diabetes prediction anthropometric cut-offs kenya africa waist circumference waist-to-height ratio |
| url | https://www.aimspress.com/article/doi/10.3934/publichealth.2021041?viewType=HTML |
| work_keys_str_mv | AT anthonymuchaimanyara optimalcutoffsoffiveanthropometricindicesandtheirpredictiveabilityoftype2diabetesinanationallyrepresentativekenyanstudy |