The main purpose of this study was to find which of the anthropometric measures body mass index (BMI), waist circumference, hip circumference and waist-to-hip ratio (WHR) were the best correlate for glucose levels and type 2 diabetes in a large multiethnic cohort. A total of 22,293 men and women from five ethnic groups and 21 countries, and at risk of developing type 2 diabetes were analyzed. Taken individually, an increase in BMI, waist circumference or WHR had a comparable positive association with the area under the curve of glucose status from the glucose load and the risk of type 2 diabetes after adjusting for age, sex, smoking and ethnicity. The combination of BMI and WHR or of waist cicumference and hip circumference had the best explanatory power for type 2 diabetes and glucose status compared with a single anthropometric measure. Moreover, measurement of both waist circumference and hip circumference were required to optimally identify people with elevated glucose levels. Finally, significant interactions with sex were observed for waist circumference and hip circumference as well as ethnicity-related variations among several associations.
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