Date of Award

Summer 8-11-2011

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Ike S. Okosun

Second Advisor

Dr. Dan Benardot

Abstract

Abstract

Validity of waist-to-height ratio as a screening tool for type 2 diabetes risk in non-Hispanic Whites, non-Hispanic Blacks, and Mexican American Adult Women, from the ages 20-65 years of age.

Background:

A prominent screening measure for type 2 diabetes is a simple measure of waist circumference. Waist circumference is an aggregate measurement of the actual amount of total and abdominal fat accumulation and is a crucial correlate of the complexities found among obese and overweight patients. However, waist circumference does not take into consideration the frame of an individual. Hence, recent epidemiologic data have suggested the use of height adjusted waist circumference (waist-to-height ratio). The use of waist-to-height ratio in screening for type 2 diabetes is poorly understood.

Aims:

The aim of this study is to determine racial/ethnic differences in the association of the independent variables waist-to-height ratio and waist circumference, with type 2 diabetes in non-Hispanic Whites, non-Hispanic Blacks, and Mexican American adult women, ages 20-65 years old.

Methods:

Data from the NHANES 2007-2008 surveys were used. Race/ethnic specific odds ratios from univariate and multivariate logistic regression models were to estimate the associations of waist-to-height ratio and waist circumference with type 2 diabetes. In the multivariate models, adjustments were made for age and alcohol use.

Results:

In the univariate models, WC was associated with 1.06, 1.07 and 1.04 increased odds of type 2 diabetes in Mexican Americans, non-Hispanic Whites and non-Hispanic Blacks, respectively. The corresponding values waist-to-height ratio were 2.85, 3.20 and 1.88, respectively. On adjusting for confounders, WC was associated with 1.07, 1.05, and 1.05 increased odds of type 2 diabetes in Mexican Americans, non-Hispanic Whites and non-Hispanic Blacks, respectively. WHtR was associated with 2.95, 2.38, and 2.37 increased odds of type 2 diabetes in Mexican Americans, non-Hispanic Whites and non-Hispanic Blacks, respectively.

Conclusion:

This study indicates that WHtR may be a powerful anthropometric predictor of risk for type 2 diabetes for Mexican American, non-Hispanic White and non-Hispanic Black American women ages 20-65.The literature on WHtR as a screening tool for type 2 diabetes in American women is lacking. This study is one of the first to examine the association between WHtR across varying races of American women. Future researchers should explore populations of women and men in the US with more races represented.

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