| Aims: This study aimed to introduce and apply modern statistical techniques for assessing association
and predictive value of risk factors in
first-degree relatives (FDR) of patients with diabetes from
repeatedly measured diabetes data.
Methods: We used data from 1319 FDR’s of patients with diabetes followed for 8 years. Association and
predictive performance of weight (Wt), body mass index (BMI), waist and hip circumferences (WC and
HC) and their ratio (WHR), waist-height ratio (WHtR) and a body shape index (ABSI) in relation to future
diabetes were evaluated by using Cox regression and joint longitudinal-survival modeling.
Results: According to Cox regression, in total sample, WC, HC, Wt, WHtR and BMI had significant direct
association with diabetes (all p < 0.01) with the best predictive ability for WHtR (concordance probability
estimate = 0.575). Joint modeling suggested direct associations between diabetes and WC, WHR, Wt,
WHtR and BMI in total sample (all p < 0.05). According to LPML criterion, WHtR was the best predictor in
both total sample and females with LPML of
2666.27 and
2185.67, respectively. However, according to
AUC criteria, BMI had the best predictive performance with AUC-JM = 0.7629 and dAUC-JM = 0.5883 in
total sample. In females, both AUC criteria indicated that WC was the best predictor followed by WHtR.
Conclusion: WC, WHR, Wt, WHtR and BMI are among candidate anthropometric measures to be
monitored in diabetes prevention programs. Larger multi-ethnic and multivariate research are warranted
to assess interactions and identify the best predictors in subgroups |