Waist-to-thigh ratio and diabetes among US adults: the Third National Health and Nutrition Examination Survey.

AIMS: We sought to examine whether waist-to-thigh ratio (WTR) performed better than waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR), waist circumference (WC), or body mass index (BMI) in relation to diabetes among US adults.

METHODS: Data of 6277 men and nonpregnant women 20 years or older from the Third National Health and Nutrition Examination Survey (1988-1994) were analyzed.

RESULTS: In men, AUC of WTR (0.83) was larger than that of WHtR (0.78) (P=0.003), WHpR (0.79) (P<0.001), WC (0.76) (P<0.001), and BMI (0.72) (P<0.001) for diabetes. In women, the AUC of WTR (0.80) was similar to that of WHtR (0.80) (P=0.89), WHpR (0.79) (P=0.55), and WC (0.78) (P=0.36), but larger than that of BMI (0.73) (P=0.03) for diabetes. After adjustment for potential confounders, WTR had the strongest association with diabetes in men (OR, 2.13; 95% CI, 1.57-2.88; per 1 SD increment), whereas WHpR had the strongest association with diabetes in women (OR, 1.94; 95% CI, 1.60-2.35).

CONCLUSIONS: WTR performed better than other four indices in men and WTR performed similarly to WHtR, WHpR, and waist circumference, but better than BMI in women for the association with diabetes.