Abstract
INTRODUCTION: Both body mass index (BMI) and waist circumference (WC) are associated with diabetes risk, and the difference between them in predictive ability for diabetes is still contentious. We conducted a population-based study to investigate and compare the association of them with diabetes by sex. METHODS: This study included a total of 4754 subjects aged 40-80 years with no diabetes at baseline between 2008 and 2017. Using multivariate Cox proportional hazards models, we calculated hazard ratios for diabetes according to tertiles of BMI or WC. Harrell's C statistics was applied to assess and compare the predictive ability of the models using BMI and WC. RESULTS: Both BMI and WC showed the significant positive trends with diabetes risk. In men, the extreme tertiles (BMI > 25.1 kg/m(2) and WC > 88.0 cm) provided 1.58-fold or 2.04-fold higher risk compared with the first tertiles (< 22.6 kg/m(2) and < 81.2 cm). In women, BMI > 24.4 kg/m(2) showed 3.28-fold higher risk than the first tertile (< 21.6 kg/m(2)), whereas WC ≥ 78.2 cm was more than twice as likely to suffer from diabetes as WC < 78.2 cm. BMI and WC showed a comparative performance in predicting diabetes in both sexes (P value 0.447 in men, and 0.337 in women). CONCLUSION: Both BMI and WC showed a positive association with diabetes and offered a comparative predictive performance for diabetes in both sexes. The cut-off points, BMI 25.1 kg/m(2) and WC 88.0 cm in men and BMI 24.4 kg/m(2) and WC 78.2 cm in women, might contribute to the effective prevention strategies for diabetes.