Central rather than overall obesity is related to diabetes in the Chinese population: the InterASIA study

Objective: The objective was to compare central and overall obesity measurements for identifying diabetes mellitus (DM) and impaired fasting glucose (IFG) level in the Chinese population. Research Methods and Procedures: Data for 15,236 Chinese adults between the ages of 35 and 74 years, obtained by the InterASIA Study in 2000–2001, were used for the current analyses. We analyzed the areas under the receiver operating characteristic (ROC) curves (AUCs) for waist circumference (WC), waist‐to‐hip ratio (WHR), and BMI to determine the ability of these indices to identify DM and IFG in the study sample and bootstrapped samples. WC was used as a measure of central obesity and BMI as a measure of overall obesity. Results: The prevalence rates of central and overall obesity in the study population were 33.97% and 9.78%, respectively. The prevalence rates of IFG and DM were 7.34% and 5.51%, respectively. ROC analysis revealed significant differences between AUCs for WHR (0.666, 95% confidence interval, 0.647 to 0.685) and BMI (0.622, 95% confidence interval, 0.601 to 0.642) and for WC (0.661, 95% confidence interval, 0.643 to 0.682) and BMI for identifying DM (all p < 0.0001). The analysis also revealed significant differences between AUCs for WHR (0.638, 95% confidence interval, 0.619 to 0.655) and BMI (0.607, 95% confidence interval, 0.589 to 0.627) and for WC (0.637, 95% confidence interval, 0.615 to 0.654) and BMI for identifying IFG (all p < 0.001). Discussion: Central obesity is more related to DM and IFG than is overall obesity in the Chinese population, and both WC and WHR are equally able to identify DM.