Waist circumference has heterogeneous impact on development of diabetes in different populations : Longitudinal comparative study between Australia and Iran

Aims : Comparing waist circumference (WC) role in diabetes risk prediction and diagnosis of metabolic syndrome (MS) in different populations.Methods : Population-based samples from Australia (n = 9026) and Iran (n = 8259) were studied in 2000 and followed for 4 years. Follow-up attendance was 58% and mean age was 51 vs. 47. Pearson correlations calculated between WC and other MS components. ROC for the role of WC in the prediction of incident diabetes was used.Results : Prevalences of MS (48% vs. 28%), an increased WC (58.5% vs. 54.5%), low HDL-C (35% vs. 11.2%), high triglyceride (52.2% vs. 29.6%) were significantly higher in Iran. Fasting glucose ≥5.6 mmol/L was higher in Australia (26% vs. 23%). Hypertension was no different (38%). Pearson correlations between WC and other MS components were stronger in Australians: FPG (0.32 vs. 0.2), HDL (0.47 vs. 0.16), TG (0.38 vs. 0.30) and SBP (0.38 vs. 0.36). Among women, area under ROC curve for WC as a predictor for diabetes was significantly higher for Australians (0.76 vs. 0.68, p < 0.001) with no difference among men (0.69 vs. 0.71, p = 0.4).Conclusion : WC was more strongly related to other components of MS in Australia. Association between WC and MS or incident diabetes varies between ethnicities.