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Abstract MP93: Waist Circumference Has a Stronger Association With Diabetes Than Body Mass Index: Results From a Large Health Examination of 355,310 Thai Men and Women

Background: Although obesity is known to increase the risk of diabetes, few studies have investigated the relative association of diabetes with body mass index (BMI) and waist circumference (WC) in Asian populations. Methods: Using data from the Health Check Ubon Ratchathani (HCUR) project, a large health examination of 355,510 Thai men and women aged ≥30 years in Ubon Ratchathani, Thailand, we investigated the association between BMI, WC and prevalent diabetes. Weight, height, WC and fasting blood glucose were measured using standard procedures and point-of-care glucometers. We defined diabetes as fasting blood glucose ≥126 mg%, or self-reported diabetes. Results: Among 355,510 participants, 21,838 (6.1%) had diabetes. BMI and WC were continuously and consistently associated with the risk of diabetes. There was a J-shape relationship between BMI and diabetes risk, while a threshold pattern for the association between WC and diabetes was observed. Each 1 kg/m2 higher BMI was associated with a 11% increased risk of diabetes, and each 5-cm higher WC was associated with a 35% increased risk. For every standard deviation or quintile increase, WC was more strongly associated with the risk of diabetes than BMI. After adjustment for age, sex, smoking, exercise, alcohol drinking, family history of diabetes, hypertension and cholesterol, the odds ratios for diabetes across WC quintile were 1.00 (reference), 1.03 (95%CI 0.98-1.08), 1.38 (1.30-1.47), 1.66 (1.58-1.74) and 3.16 (3.03-3.30) respectively (p for trend Conclusions: In this Thai population, we found a continuous relationship between waist circumference, BMI and diabetes across the whole range of their values, with a stronger association for waist circumference than BMI.