DETERMINATION OF THE WAIST CIRCUMFERENCE THRESHOLD FOR TYPE 2 DIABETES RISK IN PERUVIAN ADULTS

Introduction: Waist circumference (WC) increases the risk of type 2 diabetes mellitus (T2DM). Objectives: To determine WC cutoff points associated with T2DM risk in Peruvian adults. Methods: Analytical cross-sectional study using data from the 2022 Demographic and Family Health Survey (ENDES-22, by its Spanish acronym). Adults aged ≥18 years with complete data on WC, weight, height, and blood pressure and without a prior diagnosis of T2DM were included. T2DM risk was assessed using a validated questionnaire. The receiver operating characteristic (ROC) curve was used to identify the optimal WC cutoff based on sensitivity, specificity, and area under the curve (AUC). Results were validated using the 2023 ENDES database. Cramér's V (V), Cohen’s Kappa (K), and prevalence ratio (PR) were also used. Results: In women, the AUC was 0.688 (CI: 0.678–0.699; p<0.001) with a WC cutoff of 91 cm for T2DM risk. In men, AUC=0.821 (CI: 0.814–0.828; p<0.001) with a cutoff of 88 cm. For men, the international cutoff (95 cm) and the ROC-based cutoff (88 cm) showed V=0.519; 0.489, K=0.507; 0.496, sensitivity=64%; 82% and specificity=87%; 61%, respectively. In women, using 82 cm and 91 cm as cutoffs yielded V=0.115; 0.240, K=0.060; 0.203, sensitivity=88%; 71% and specificity=23%; 57%, respectively. Results were replicated in ENDES-2023, with similar values. Conclusion: WC is effective for T2DM screening in men but limited in women.