Anthropometric Measures, Cardiometabolic and Hepatic Indices, and Cut-off Points for Predicting Type 2 Diabetes Mellitus in Southwest Iran: A Cross-Sectional Study from the Enrolment Phase of the Hoveyzeh Cohort Study

Background: Cut-off points for anthropometric measures associated with diabetes may vary across different ethnic groups. Objectives: This study aimed to identify the optimal cut-off values for these measures and their relationship with cardiometabolic and hepatic indices to predict type 2 diabetes mellitus (T2DM) in southwest Iran. Methods: This cross-sectional study was conducted in Hoveyzeh, Iran, and included a total of 7,300 individuals (1,607 with T2DM and 5,693 healthy participants). Anthropometric, cardiometabolic, and hepatic indices were calculated. Results: The visceral adiposity index (VAI) showed the highest correlation with cardiometabolic indices, such as the cardiometabolic index and lipid accumulation product. The conicity index (CI) had the strongest correlation with hepatic indices, including the hepatic steatosis index and the Alcoholic Liver Disease/Non-alcoholic Fatty Liver Disease (ALD/NAFLD) index. The atherogenic index of plasma was the most significant predictor of T2DM in the Hoveyzeh population for both men (OR: 3.39; CI: 2.38 - 4.81) and women (OR: 5.68; CI: 4.20 - 7.68). The optimal cut-off values for several anthropometric measures were higher in men than in women: BMI (28.0 vs. 25.48), Waist/Height ratio (0.64 vs. 0.56), Weight-adjusted waist index (11.83 vs. 10.76), CI (1.35 vs. 1.29), body roundness index (8.43 vs. 7.33), relative fat mass (44.63 vs. 28.5), and lipid accumulation product (67.23 vs. 67.04). Conversely, the cut-off values for optimal waist circumference (99.45 vs. 98.35), Waist/Hip ratio (0.99 vs. 0.96), VAI (2.22 vs. 2.19), and abdominal volume index (20 vs. 19.6) were higher in women than in men. Conclusions: The atherogenic index of plasma is a highly predictive indicator of T2DM. Our results suggest that novel anthropometric and cardiometabolic indices could serve as accessible and cost-effective strategies for assessing health outcomes related to T2DM.