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Optimal Cut-off Points of BMI WC and WHR for Screening of Pre-Diabetes and Diabetes Over 35 Years Old People

Received: Dec. 06, 2018    Accepted: Dec. 20, 2018    Published: Jan. 29, 2019
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Abstract

Using BMI, WC and WHR to investigate and compare these screening tool for IFG, IGT and diabetes subjects in Shanghai China; and to identify the optimal cut-off points of BMI, WC and WHR for screening pre-diabetes (Pre-DM) and diabetes (DM) over 35 years old people. Totally 3,195 aged 35 years old and above people who attended community epidemiological survey of diabetes mellitus. Using ADA criteria (2010), the participants were classified as normal, Pre-DM or DM according to test results of blood glucose. The area under ROC curve (AUROC) for BMI, WC and WHR were calculated; as well as the sensitivity, specificity and Youden index under different BMI or WHR cut-off points. Among these people, age is (61.07±10.08), and BMI and WHR are respectively (25.12±3.29) and (0.87±0.06). The positive rate of screening of DM is 11.36% and that of Pre-DM is 38.57%. There are correlation between blood glucose and BMI or WHR (p<0.05). With the increase of BMI or WHR cut-off point, the screening sensitivity (YI, Sp and Se) for DM or pre-DM are decreasing; but the area under ROC (AUROC) increases firstly and then decreases (inflection point: WHR≥0.8~0.9 and BMI≥23 for pre-DM, WHR≥0.9 and BMI≥24 for DM). The combined screening efficacy of BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8), and YI is the highest. Using HbA1C as standard of judgment seems to be better than blood glucose in screening for DM. BMI≥23, WC≥90 cm or WHR≥0.8 is the optimal cut-off point for screening DM and pre-DM, and the screening efficacy of BMI is better than WC and WHR. BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8). HbA1C is better than FBG and OGTT as standard of judgment in screening.

DOI 10.11648/j.wjph.20190401.11
Published in World Journal of Public Health ( Volume 4, Issue 1, March 2019 )
Page(s) 1-9
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes, Pre-Diabetes, Cut-off Points, Body Mass Index, Waist to Hip Ratio, Screening

References
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    Anle Li, Yanyun Li, Fang Xiang, Yiying Zhang, Qinping Yang, et al. (2019). Optimal Cut-off Points of BMI WC and WHR for Screening of Pre-Diabetes and Diabetes Over 35 Years Old People. World Journal of Public Health, 4(1), 1-9. https://doi.org/10.11648/j.wjph.20190401.11

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    ACS Style

    Anle Li; Yanyun Li; Fang Xiang; Yiying Zhang; Qinping Yang, et al. Optimal Cut-off Points of BMI WC and WHR for Screening of Pre-Diabetes and Diabetes Over 35 Years Old People. World J. Public Health 2019, 4(1), 1-9. doi: 10.11648/j.wjph.20190401.11

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    AMA Style

    Anle Li, Yanyun Li, Fang Xiang, Yiying Zhang, Qinping Yang, et al. Optimal Cut-off Points of BMI WC and WHR for Screening of Pre-Diabetes and Diabetes Over 35 Years Old People. World J Public Health. 2019;4(1):1-9. doi: 10.11648/j.wjph.20190401.11

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  • @article{10.11648/j.wjph.20190401.11,
      author = {Anle Li and Yanyun Li and Fang Xiang and Yiying Zhang and Qinping Yang and Zhihao Hu and Qian Peng},
      title = {Optimal Cut-off Points of BMI WC and WHR for Screening of Pre-Diabetes and Diabetes Over 35 Years Old People},
      journal = {World Journal of Public Health},
      volume = {4},
      number = {1},
      pages = {1-9},
      doi = {10.11648/j.wjph.20190401.11},
      url = {https://doi.org/10.11648/j.wjph.20190401.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.wjph.20190401.11},
      abstract = {Using BMI, WC and WHR to investigate and compare these screening tool for IFG, IGT and diabetes subjects in Shanghai China; and to identify the optimal cut-off points of BMI, WC and WHR for screening pre-diabetes (Pre-DM) and diabetes (DM) over 35 years old people. Totally 3,195 aged 35 years old and above people who attended community epidemiological survey of diabetes mellitus. Using ADA criteria (2010), the participants were classified as normal, Pre-DM or DM according to test results of blood glucose. The area under ROC curve (AUROC) for BMI, WC and WHR were calculated; as well as the sensitivity, specificity and Youden index under different BMI or WHR cut-off points. Among these people, age is (61.07±10.08), and BMI and WHR are respectively (25.12±3.29) and (0.87±0.06). The positive rate of screening of DM is 11.36% and that of Pre-DM is 38.57%. There are correlation between blood glucose and BMI or WHR (p<0.05). With the increase of BMI or WHR cut-off point, the screening sensitivity (YI, Sp and Se) for DM or pre-DM are decreasing; but the area under ROC (AUROC) increases firstly and then decreases (inflection point: WHR≥0.8~0.9 and BMI≥23 for pre-DM, WHR≥0.9 and BMI≥24 for DM). The combined screening efficacy of BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8), and YI is the highest. Using HbA1C as standard of judgment seems to be better than blood glucose in screening for DM. BMI≥23, WC≥90 cm or WHR≥0.8 is the optimal cut-off point for screening DM and pre-DM, and the screening efficacy of BMI is better than WC and WHR. BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8). HbA1C is better than FBG and OGTT as standard of judgment in screening.},
     year = {2019}
    }
    

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    AU  - Anle Li
    AU  - Yanyun Li
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    AU  - Yiying Zhang
    AU  - Qinping Yang
    AU  - Zhihao Hu
    AU  - Qian Peng
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    DO  - 10.11648/j.wjph.20190401.11
    T2  - World Journal of Public Health
    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
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    EP  - 9
    PB  - Science Publishing Group
    SN  - 2637-6059
    UR  - https://doi.org/10.11648/j.wjph.20190401.11
    AB  - Using BMI, WC and WHR to investigate and compare these screening tool for IFG, IGT and diabetes subjects in Shanghai China; and to identify the optimal cut-off points of BMI, WC and WHR for screening pre-diabetes (Pre-DM) and diabetes (DM) over 35 years old people. Totally 3,195 aged 35 years old and above people who attended community epidemiological survey of diabetes mellitus. Using ADA criteria (2010), the participants were classified as normal, Pre-DM or DM according to test results of blood glucose. The area under ROC curve (AUROC) for BMI, WC and WHR were calculated; as well as the sensitivity, specificity and Youden index under different BMI or WHR cut-off points. Among these people, age is (61.07±10.08), and BMI and WHR are respectively (25.12±3.29) and (0.87±0.06). The positive rate of screening of DM is 11.36% and that of Pre-DM is 38.57%. There are correlation between blood glucose and BMI or WHR (p<0.05). With the increase of BMI or WHR cut-off point, the screening sensitivity (YI, Sp and Se) for DM or pre-DM are decreasing; but the area under ROC (AUROC) increases firstly and then decreases (inflection point: WHR≥0.8~0.9 and BMI≥23 for pre-DM, WHR≥0.9 and BMI≥24 for DM). The combined screening efficacy of BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8), and YI is the highest. Using HbA1C as standard of judgment seems to be better than blood glucose in screening for DM. BMI≥23, WC≥90 cm or WHR≥0.8 is the optimal cut-off point for screening DM and pre-DM, and the screening efficacy of BMI is better than WC and WHR. BMI merged WHR is the best combination choice (cut-off point of BMI and WHR are respectively 23 and 0.8). HbA1C is better than FBG and OGTT as standard of judgment in screening.
    VL  - 4
    IS  - 1
    ER  - 

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Author Information
  • Jiading District Center for Disease Control and Prevention, Shanghai, China

  • Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China

  • Jiading District Center for Disease Control and Prevention, Shanghai, China

  • Jiading District Center for Disease Control and Prevention, Shanghai, China

  • Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China

  • Jiading District Center for Disease Control and Prevention, Shanghai, China

  • Jiading District Center for Disease Control and Prevention, Shanghai, China

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