Anthropometric measures associated with diabetes mellitus: a comparative cross-sectional study among adults availing health services in an urban underprivileged area of Bangalore city

Mahin Mundra; Sanglap Masih; Johann Thomas; Avita Rose Johnson

doi:10.18203/2394-6040.ijcmph20252840

Authors

Mahin Mundra Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India
Sanglap Masih Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India
Johann Thomas Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India
Avita Rose Johnson Department of Community Health, St. John’s Medical College, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20252840

Keywords:

Anthropometry, Diabetes mellitus, Obesity, Urban health

Abstract

Background: Diabetes affects about 12% of urban Indian adults. Obesity is a key risk factor, measurable through several anthropometric indices. This study examined which measures are most strongly associated with diabetes among adults in an underprivileged urban area of Bangalore.

Methods: A comparative cross-sectional study was conducted among adults aged ≥30 years attending a health centre. Socio-demographic, lifestyle, and dietary data were collected. Anthropometric parameters including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and waist-to-calf ratio (WCR) were assessed and compared between 84 diabetics and 84 non-diabetics. Independent t-test and Mann Whitney U tests were performed.

Results: Diabetics were over six times more likely to have higher WCR than non-diabetics (AOR=6.43; 95% CI: 1.90-21.7; p=0.003). No significant differences were found for BMI, WC, WHR, or WHtR. Dietary patterns differed significantly: diabetics were more likely to lack daily fruit and vegetable intake (AOR=3.2; 95% CI: 1.27-8.12; p=0.002) and more likely to consume fried, salty, or junk foods daily (AOR=9.14; 95% CI: 4.09-20.41; p<0.001). No notable differences were observed in hypertension, alcohol use, smoking, or physical activity.

Conclusions: Waist-to-calf ratio (WCR) is a significant marker of diabetes in this urban Indian population, alongside unhealthy dietary habits. Establishing appropriate WCR cut-offs could help identify high-risk individuals and guide early preventive interventions.

Metrics

Metrics Loading ...

References

Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932-38. DOI: https://doi.org/10.4103/ijo.IJO_1627_21

Sharma P, Dilip TR, Kulkarni A, Mishra US, Shejul Y. Risk of diabetes and expected years in life without diabetes among adults from an urban community in India: findings from a retrospective cohort. BMC Public Health. 2024;24:1048. DOI: https://doi.org/10.1186/s12889-024-18465-2

Aggarwal S, Kakkar R, Mohan V. Urban-rural differences in the prevalence of diabetes among adults in Haryana, India: The ICMR-INDIAB study (ICMR-INDIAB-18). Diabetes Ther. 2024;15(7):1597-613. DOI: https://doi.org/10.1007/s13300-024-01602-w

Wells JCK, Pomeroy E, Walimbe SR, Popkin BM, Yajnik CS. The elevated susceptibility to diabetes in India: an evolutionary perspective. Front Public Health 2016;4:145. DOI: https://doi.org/10.3389/fpubh.2016.00145

Czernichow S, Kengne AP, Stamatakis E, Hamer M, Batty GD. Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk? Evidence from an individual-participant meta-analysis of 82 864 participants from nine cohort studies. Obes Rev. 2011;12(9):680-7. DOI: https://doi.org/10.1111/j.1467-789X.2011.00879.x

Kalra S, Mithal A, Zargar AH, Sethi B, Dharmalingam M, Ghosh S, et al. Indian phenotype characteristics among patients with type 2 diabetes mellitus: insights from a non-interventional nationwide registry in India. touchREV Endocrinol. 2022;18(1):63-70. DOI: https://doi.org/10.17925/EE.2022.18.1.63

Mirzaei M, Khajeh M. Comparison of anthropometric indices (body mass index, waist circumference, waist to hip ratio and waist to height ratio) in predicting risk of type II diabetes in the population of Yazd, Iran. Diabetes Metab Syndr. 2018;12(5):677-82. DOI: https://doi.org/10.1016/j.dsx.2018.04.026

Dai M, Xia B, Xu J, Zhao W, Chen D, Wan X. Association of waist-calf circumference ratio, waist circumference, calf circumference, and body mass index with all-cause and cause-specific mortality in older adults: a cohort study. BMC Public Health. 2023;23:1777. DOI: https://doi.org/10.1186/s12889-023-16711-7

Khader Y, Batieha A, Jaddou H, El-Khateeb M, Ajlouni K. The performance of anthropometric measures to predict diabetes mellitus and hypertension among adults in Jordan. BMC Public Health. 2019;19(1):1416. DOI: https://doi.org/10.1186/s12889-019-7801-2

Hajian-Tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults? Int J Prev Med. 2015;6:5. DOI: https://doi.org/10.4103/2008-7802.151434

Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev. 2010;23(2):247-69. DOI: https://doi.org/10.1017/S0954422410000144

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Classification and diagnosis of Diabetes: Standards of care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S19-S40. DOI: https://doi.org/10.2337/dc23-S002

Taylor R, Holman RR. Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Clin Sci. 2015;128(7):405-10. DOI: https://doi.org/10.1042/CS20140553

Narayan KMV, Kanaya AM. Why are South Asians prone to type 2 diabetes? A hypothesis based on underexplored pathways. Diabetologia. 2020;63(6):1103-9. DOI: https://doi.org/10.1007/s00125-020-05132-5

Castro AV, Kolka CM, Kim SP, Bergman RN. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol. 2014;58(6):600-9. DOI: https://doi.org/10.1590/0004-2730000003223

Champaiboon J, Petchlorlian A, Manasvanich BA, Ubonsutvanich N, Jitpugdee W, Kittiskulnam P, et al. Calf circumference as a screening tool for low skeletal muscle mass: cut-off values in independent Thai older adults. BMC Geriatr. 2023;23(1):826. DOI: https://doi.org/10.1186/s12877-023-04543-4

Choe EY, Lee YH, Choi YJ, Huh BW, Lee BW, Kim SK, et al. Waist-to-calf circumstance ratio is an independent predictor of hepatic steatosis and fibrosis in patients with type 2 diabetes. J Gastroenterol Hepatol. 2018;33(5):1082-91. DOI: https://doi.org/10.1111/jgh.14011

Rao HA, Harischandra P, Yadav S. Correlation of waist to calf circumference ratio and carotid intima-media thickness in diabetes mellitus. Curr Diabetes Rev. 2021;17(3):387-93. DOI: https://doi.org/10.2174/1573399816999200729124903

Wu C, Kao T, Chang Y, Peng T, Wu L, Yang H, et al. Does the additional component of calf circumference refine metabolic syndrome in correlating with cardiovascular risk? J Clin Endocrinol Metab. 2018;103(3):1151-60. DOI: https://doi.org/10.1210/jc.2017-02320

Sinha S, Haque M. Obesity, diabetes mellitus, and vascular impediment as consequences of excess processed food consumption. Cureus. 2022;14(9):e28762. DOI: https://doi.org/10.7759/cureus.28762

Sami W, Ansari T, Butt NS, Hamid MRA. Effect of diet on type 2 diabetes mellitus: A review. Int J Health Sci. 2017;11(2):65-71.

Anjana RM, Pradeepa R, Das AK, Deepa M, Bhansali A, Joshi SR, et al. Physical activity and inactivity patterns in India- results from the ICMR-INDIAB study (Phase-1) [ICMR-INDIAB-5]. Int J Behav Nutr Phys Act. 2014;11(1):26. DOI: https://doi.org/10.1186/1479-5868-11-26

World Health Organisation. Healthy Diet Factsheet. Available at: https://www.who.int/news-room/fact-sheets/detail/healthy-diet. Accessed on 7 November 2023.