Diagnostic Accuracy of Anthropometric Markers of Obesity for Prediabetes: A Systematic Review and Meta-Analysis

Víctor Juan  Vera-Ponce; Fiorella E.  Zuzunaga-Montoya; Joan A.  Loayza-Castro; Andrea P.  Ramirez-Ortega; Jenny Raquel  Torres-Malca; Rosa A.  García-Lara; Cori Raquel  Iturregui Paucar; Mario J.  Valladares-Garrido; Jhony A. De La  Cruz-Vargas

doi:10.6000/1929-6029.2023.12.15

Authors

Víctor Juan Vera-Ponce Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú https://orcid.org/0000-0003-4075-9049
Fiorella E. Zuzunaga-Montoya Universidad Científica del Sur, Lima, Perú
Joan A. Loayza-Castro Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
Andrea P. Ramirez-Ortega Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
Jenny Raquel Torres-Malca Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
Rosa A. García-Lara Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
Cori Raquel Iturregui Paucar Universidad Tecnológica del Perú, Lima, Perú
Mario J. Valladares-Garrido Universidad Continental Lima, Perú
Jhony A. De La Cruz-Vargas Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú

DOI:

https://doi.org/10.6000/1929-6029.2023.12.15

Keywords:

Prediabetic state, body weights and measures, body mass index, waist circumference, waist-height ratio, sensitivity and specificity (source: MeSH NLM)

Abstract

Introduction: Prediabetes is a significant public health concern due to its high risk of progressing to diabetes. Anthropometric measures of obesity, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) have been demonstrated as key risk factors in the development of prediabetes. However, there is a lack of clarity on the diagnostic accuracy and cut-off points of these measures.

Objective: To determine the diagnostic accuracy of these anthropometric measures for their most effective use in identifying prediabetes.

Methodology: A systematic review (SR) with metanalysis of observational studies was carried out. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. For the meta-analysis, sensitivity and specificity, together with their 95% confidence intervals (CI 95%) were calculated.

Results: Among all the manuscripts chosen for review, we had four cross-sectional studies, and three were classified as cohort studies.

The forest plots showed the combined sensitivity and specificity for both cross-sectional and cohort studies. For cross-sectional studies, the values were as follows: BMI had a sensitivity of 0.63 and specificity of 0.56, WC had a sensitivity of 0.59 and specificity of 0.58, and WHtR had a sensitivity of 0.63 and specificity of 0.73. In the cohort studies, the combined sensitivity and specificity were: BMI at 0.70 and 0.45, WC at 0.68 and 0.56, and WHtR at 0.68 and 0.56, respectively. All values are provided with 95% confidence intervals.

Conclusions: This systematic review and meta-analysis evaluated the diagnostic accuracy of BMI, WC, and WHtR in identifying prediabetes. The results showed variations in sensitivity and specificity, with WHtR having the highest specificity in cross-sectional studies and BMI having improved sensitivity in cohort studies.

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