Wrist circumference as a novel predictor of diabetes and prediabetes: Results of cross-sectional and 8.8-year follow-up studies

Objective: Our objective was to examine whether wrist circumference is associated with incident type 2 diabetes mellitus, independently of general (body mass index [BMI]) or central (waist circumference [WC]) adiposity measures in a cohort of an Iranian adult population. Research Design and Methods: A total of 9330 subjects ≥20 years of age were included in the cross-sectional study. For prospective analysis, subjects with prevalent diabetes were excluded, leaving 6393 subjects (2716 males and 3677 females). The standard 2-hour postchallenge plasma glucose test was performed at baseline and during follow-up. Cox regression analysis was used to estimate the hazard ratio of diabetes for wrist circumference. Results: During a mean follow-up of 8.8 years, 649 new cases of diabetes occurred. At baseline, using linear regression models, we showed significant linear associations between wrist circumference and diabetes risk factors in both genders, and this association remained significant after controlling for BMI or WC among females. In prospective evaluation, wrist circumference was significantly associated with incident diabetes (multivariable-adjusted hazard ratio = 1.17 [1.03-1.32] and 1.31 [1.18-1.45] for males and females, respectively). After controlling for the subjects' BMI or WC, wrist circumference was an independent predictor of diabetes only among females. Wrist circumference was an independent predictor of metabolic syndrome only among women even after adjustment for BMI, WC, or both. Conclusions: Wrist circumference is a significant predictor of diabetes in both genders of adult population. However, its predictability is independent of BMI or WC only among females. Because of its simple and easy-to-detect nature, wrist circumference could be considered as a new anthropometric assessment for prediction of type 2 diabetes and metabolic syndrome.