Limits...
Utility of current obesity thresholds in signaling diabetes risk in the James Bay Cree of Eeyou Istchee.

Manjoo P, Dannenbaum D, Joseph L, Torrie J, Dasgupta K - BMJ Open Diabetes Res Care (2015)

Bottom Line: For other current thresholds, estimated optimal values were higher and none had a PLR above 2.A BMI of 30 kg/m(2) in women and men, and a 102 cm waist circumference in men, are meaningful obesity thresholds in this Aboriginal population.Other thresholds require a further evaluation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine , University of Victoria , Victoria, British Columbia , Canada.

ABSTRACT

Objective: The anthropometric thresholds signaling type 2 diabetes risk have not been well defined for Aboriginal communities. This study examined current thresholds in terms of ability to capture diabetes risk in the Cree of Eeyou Istchee in northern Quebec, Canada.

Research design and methods: The study cohort for this analysis included adult participants from the Nituuchischaayihtitaau Aschii Multi-Community Environment and Health Study with complete data on anthropometric measures, fasting glucose, and insulin. Diabetes risk was defined as Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value >2. Positive and negative likelihood ratios (PLR, NLR) of existing obesity thresholds were evaluated (WHO; International Diabetes Federation, IDF; Adult Treatment Panel III, ATP III). Receiver operating curves were examined to estimate optimal thresholds. In a sensitivity analysis, diabetes risk was defined as HOMA-IR >2.7.

Results: The WHO 30 kg/m(2) body mass index (BMI) threshold performed well in women (PLR 5.56, 95% CI 1.95 to 15.9; NLR 0.24, 95% CI 0.19 to 0.31) and men (PLR 7.51, 95% CI 2.94 to 19.2; NLR 0.33, 95% CI 0.27 to 0.41). It was close to the estimated optimal threshold (28.5 kg/m(2)). The ATP III waist circumference threshold (102 cm) performed well in men (PLR 4.64, 95% CI 2.47 to 8.71; NLR 0.21, 95% CI 0.16 to 0.28) and was close to the estimated optimal threshold (101 cm). With diabetes risk defined at HOMA-IR >2.7, PLR values were slightly lower with narrower 95% CIs and optimal thresholds were slightly higher; PLR values remained above 3. For other current thresholds, estimated optimal values were higher and none had a PLR above 2.

Conclusions: A BMI of 30 kg/m(2) in women and men, and a 102 cm waist circumference in men, are meaningful obesity thresholds in this Aboriginal population. Other thresholds require a further evaluation.

No MeSH data available.


Related in: MedlinePlus

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BMJDRC2015000114F1: Participant flow.

Mentions: There are nearly 10 000 adults living in Eeyou Istchee. A total of 1405 individuals were consented for data collection procedures, which included medical chart review (figure 1). This included 860 adults. Among these adults, 16 did not have WC data, 53 did not have a chart review, 2 had type 1 diabetes, and in 6, prediabetes/diabetes status was not clear from the data available. Seven hundred and eighty-three adults were retained in the present analyses (783/860, 91%). In adults excluded, mean HOMA-IR was >6 both in women and in men, and characteristics (results not shown) were similar to those in the upper two HOMA-IR categories of those retained (ie, study cohort, table 1).


Utility of current obesity thresholds in signaling diabetes risk in the James Bay Cree of Eeyou Istchee.

Manjoo P, Dannenbaum D, Joseph L, Torrie J, Dasgupta K - BMJ Open Diabetes Res Care (2015)

Participant flow.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4537917&req=5

BMJDRC2015000114F1: Participant flow.
Mentions: There are nearly 10 000 adults living in Eeyou Istchee. A total of 1405 individuals were consented for data collection procedures, which included medical chart review (figure 1). This included 860 adults. Among these adults, 16 did not have WC data, 53 did not have a chart review, 2 had type 1 diabetes, and in 6, prediabetes/diabetes status was not clear from the data available. Seven hundred and eighty-three adults were retained in the present analyses (783/860, 91%). In adults excluded, mean HOMA-IR was >6 both in women and in men, and characteristics (results not shown) were similar to those in the upper two HOMA-IR categories of those retained (ie, study cohort, table 1).

Bottom Line: For other current thresholds, estimated optimal values were higher and none had a PLR above 2.A BMI of 30 kg/m(2) in women and men, and a 102 cm waist circumference in men, are meaningful obesity thresholds in this Aboriginal population.Other thresholds require a further evaluation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine , University of Victoria , Victoria, British Columbia , Canada.

ABSTRACT

Objective: The anthropometric thresholds signaling type 2 diabetes risk have not been well defined for Aboriginal communities. This study examined current thresholds in terms of ability to capture diabetes risk in the Cree of Eeyou Istchee in northern Quebec, Canada.

Research design and methods: The study cohort for this analysis included adult participants from the Nituuchischaayihtitaau Aschii Multi-Community Environment and Health Study with complete data on anthropometric measures, fasting glucose, and insulin. Diabetes risk was defined as Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value >2. Positive and negative likelihood ratios (PLR, NLR) of existing obesity thresholds were evaluated (WHO; International Diabetes Federation, IDF; Adult Treatment Panel III, ATP III). Receiver operating curves were examined to estimate optimal thresholds. In a sensitivity analysis, diabetes risk was defined as HOMA-IR >2.7.

Results: The WHO 30 kg/m(2) body mass index (BMI) threshold performed well in women (PLR 5.56, 95% CI 1.95 to 15.9; NLR 0.24, 95% CI 0.19 to 0.31) and men (PLR 7.51, 95% CI 2.94 to 19.2; NLR 0.33, 95% CI 0.27 to 0.41). It was close to the estimated optimal threshold (28.5 kg/m(2)). The ATP III waist circumference threshold (102 cm) performed well in men (PLR 4.64, 95% CI 2.47 to 8.71; NLR 0.21, 95% CI 0.16 to 0.28) and was close to the estimated optimal threshold (101 cm). With diabetes risk defined at HOMA-IR >2.7, PLR values were slightly lower with narrower 95% CIs and optimal thresholds were slightly higher; PLR values remained above 3. For other current thresholds, estimated optimal values were higher and none had a PLR above 2.

Conclusions: A BMI of 30 kg/m(2) in women and men, and a 102 cm waist circumference in men, are meaningful obesity thresholds in this Aboriginal population. Other thresholds require a further evaluation.

No MeSH data available.


Related in: MedlinePlus