Comparison of the Ability of Anthropometric Indices to Predict the Risk of Diabetes Mellitus in South African Males: SANHANES-1

Machoene D Sekgala; Ronel Sewpaul; Maretha Opperman; Zandile J Mchiza

doi:10.3390/ijerph19063224

Comparison of the Ability of Anthropometric Indices to Predict the Risk of Diabetes Mellitus in South African Males: SANHANES-1

Int J Environ Res Public Health. 2022 Mar 9;19(6):3224. doi: 10.3390/ijerph19063224.

Authors

Machoene D Sekgala^{1

2}, Ronel Sewpaul², Maretha Opperman³, Zandile J Mchiza^{1

4}

Affiliations

¹ School of Public Health, University of the Western Cape, Bellville 7535, South Africa.
² Human and Social Capabilities, Human Sciences Research Council, Cape Town 8000, South Africa.
³ Department of Biotechnology and Consumer Science, Cape Peninsula University of Technology, Cape Town 7535, South Africa.
⁴ Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa.

Abstract

This study aimed to assess the sensitivity of body mass index (BMI) to predict the risk of diabetes mellitus (DM) and whether waist circumference (WC), waist-to-hip (WHR) and waist-to-height (WHtR) ratios are better predictors of the risk of DM than BMI in South African men aged 20 years and older. Data from the first South African National Health and Nutrition Examination Survey (SANHANES-1) were used. Overall, 1405 men who had valid HbA1c outcomes were included. The sensitivity, specificity, and optimal cut-off points for predicting DM were determined using the receiver operating characteristic (ROC) curve analysis. A total of 34.6% percent of the study participants were overweight/obese, while 10.5%, 10.4%, 36.6% and 61.0% had HbA1c, WC, WHR and WHtR above the normal reference ranges, respectively. Based on age-adjusted logistic regression analysis, the highest likelihood of DM was observed for those participants who had increased WC and WHtR (odds ratios [OR] were 6.285 (95% CI: 4.136−9.550; p < 0.001) and 8.108 (95% CI: 3.721−17.667; p < 0.001)). The ROC curve analyses for WC, WHR, and WHtR displayed excellent ability to predict the risk of DM, with their areas under the curve (AUC) being 80.4%, 80.2% and 80.8%, respectively. The overall cut-off points to predict the risk of DM for WC, WHR, and WHtR were ≥88.95 cm, ≥0.92, and >0.54, respectively. The ROC analysis for BMI, on the other hand, showed acceptable ability to predict the risk of DM (AUC = 75.6%), with its cut-off point being ≥24.64 kg/m2. Even after stratifying the data by two age groups, WHtR remained a superior index to predict DM, especially in the younger age group. To conclude, no significant differences were observed between the AUC for BMI the AUCs for other indices. However, the AUCs for these indices showed significant excellent ability as opposed to the significant acceptable ability of BMI to predict DM in adult South African men.

Keywords: South Africa; body mass index; diabetes mellitus; waist circumference; waist-to-height ratio; waist-to-hip ratio.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Body Mass Index
Diabetes Mellitus* / epidemiology
Female
Glycated Hemoglobin
Humans
Male
Nutrition Surveys
ROC Curve
Risk Factors
South Africa / epidemiology
Waist Circumference
Waist-Height Ratio*
Waist-Hip Ratio

Substances

Glycated Hemoglobin A