Sensitivity and specificity of anthropometrics for the prediction of diabetes in a biracial cohort

Objective: To evaluate the ability of body mass index, waist circumference, waist-to-hip ratio, and combinations of these variables to discriminate in dividuals who will develop diabetes in adulthood. Research Methods and Procedures: Data were from 45- to 64-year-old men and women who were members of the Atherosclerosis Risk in Communities cohort. T he analysis sample consisted of 12,814 African American and white participa nts who were free of diabetes at baseline. Body mass index, waist circumfer ence, waist-to-hip ratio, and diabetes incidence (defined as one glucose me asure greater than or equal to 126 mg/dL after fasting for at least 8 hours , one nonfasting glucose measure greater than or equal to 200 mg/dL, and se lf-report of diabetes or report of taking medication for diabetes). Results: 1515 new cases of diabetes were identified over the 9-year follow- up. Areas under receiver operating characteristic curves ranged from 0.66 t o 0.73 for single measures. The curves were smooth, with no indication of a threshold. Waist tended to have the highest receiver operating characteris tic statistic in all groups, but differences were small. Discussion: The three anthropometric indices tested were approximately equi valent in their ability to predict diabetes. Sensitivity and specificities differed among ethnic and gender groups.