Waist-to-Height Ratio as a Predictor of Early Metabolic Complications in Type 2 Diabetes
DOI:
https://doi.org/10.61336/jdme.0402.03Keywords:
Waist-to-height ratio, type 2 diabetes mellitus, central obesity, insulin resistance, dyslipidemia, metabolic complications, visceral adiposityAbstract
Waist-to-height ratio (WHtR) has been proposed as a simple anthropometric indicator of central adiposity and may provide additional information regarding metabolic risk beyond body mass index (BMI). This study evaluated the association between WHtR and early metabolic complications among adults with type 2 diabetes mellitus (T2DM). A cross-sectional clinical assessment was performed among 198 adults with T2DM aged 35–70 years. Waist circumference, height, weight, and BMI were recorded, while fasting blood samples were obtained for measurement of glucose, HbA1c, insulin, lipid profile, alanine aminotransferase, uric acid, high-sensitivity C-reactive protein, and serum creatinine. Early metabolic complications were defined as the presence of insulin resistance, atherogenic dyslipidemia, elevated liver enzymes, hyperuricemia, or low-grade systemic inflammation. WHtR was calculated by dividing waist circumference by height and participants were categorized according to predefined WHtR ranges. Higher WHtR was associated with increased HbA1c, fasting insulin, HOMA-IR, triglycerides, alanine aminotransferase, uric acid, and hs-CRP concentrations. Participants with WHtR ≥0.60 demonstrated a substantially greater prevalence of multiple metabolic abnormalities compared with those with WHtR <0.50. In correlation analyses, WHtR showed significant associations with HOMA-IR, triglyceride-to-HDL cholesterol ratio, ALT, uric acid, and hs-CRP. After adjustment for age, sex, diabetes duration, physical activity, and BMI, WHtR remained independently associated with the presence of two or more early metabolic complications. Participants in the highest WHtR category had approximately 3.1-fold greater odds of multiple metabolic abnormalities compared with those in the lowest category. These findings suggest that WHtR may serve as a practical anthropometric marker for identifying adults with T2DM who have an increased burden of early metabolic complications.
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