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Waist-to-thigh ratio and diabetes among US adults: The Third National Health and Nutrition Examination Survey

  • Chaoyang Li
    Correspondence
    Corresponding author at: Centers for Disease Control and Prevention, 4770 Buford Highway, MS K66, Atlanta, GA 30341, United States. Tel.: +1 770 488 5494; fax: +1 770 488 8150.
    Affiliations
    Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
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  • Earl S. Ford
    Affiliations
    Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
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  • Guixiang Zhao
    Affiliations
    Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
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  • Henry S. Kahn
    Affiliations
    Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
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  • Ali H. Mokdad
    Affiliations
    Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
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      Abstract

      Aims

      We sought to examine whether waist-to-thigh ratio (WTR) performed better than waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR), waist circumference (WC), or body mass index (BMI) in relation to diabetes among US adults.

      Methods

      Data of 6277 men and nonpregnant women 20 years or older from the Third National Health and Nutrition Examination Survey (1988–1994) were analyzed.

      Results

      In men, AUC of WTR (0.83) was larger than that of WHtR (0.78) (P = 0.003), WHpR (0.79) (P < 0.001), WC (0.76) (P < 0.001), and BMI (0.72) (P < 0.001) for diabetes. In women, the AUC of WTR (0.80) was similar to that of WHtR (0.80) (P = 0.89), WHpR (0.79) (P = 0.55), and WC (0.78) (P = 0.36), but larger than that of BMI (0.73) (P = 0.03) for diabetes. After adjustment for potential confounders, WTR had the strongest association with diabetes in men (OR, 2.13; 95% CI, 1.57–2.88; per 1 SD increment), whereas WHpR had the strongest association with diabetes in women (OR, 1.94; 95% CI, 1.60–2.35).

      Conclusions

      WTR performed better than other four indices in men and WTR performed similarly to WHtR, WHpR, and waist circumference, but better than BMI in women for the association with diabetes.

      Abbreviations:

      AUC (area under curve), BMI (body mass index), CDC (Centers for Disease Control and Prevention), CI (confidence interval), CRP (C-reactive protein), NHANES (Third National Health and Nutrition Examination Survey), OR (odds ratio), SD (standard deviation), SE (standard error), WC (waist circumference), WHO (World Health Organization), WHpR (waist-to-hip ratio), WHtR (waist-to-height ratio), WTR (waist-to-thigh ratio)

      Keywords

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