To assess the association of indicators of general and abdominal obesity with the prevalence of type 2 diabetes (T2DM) and intermediate hyperglycaemia (IHG) in the Chinese population.

We used data of 50 905 adults aged 18–79 years in the 2002 China National Nutrition and Health Survey. Recommended Chinese cut-off values were used for BMI (24 kg/m2) and waist circumference (WC; 85 cm in men, 80 cm in women). Optimal cut-offs for waist:height ratio (WHtR) were determined from analyses of receiver-operating characteristic (ROC) curves.

The prevalence of T2DM and IHG was 2·6 % and 1·9 % respectively. ROC curve analyses indicated 0·5 as the optimal cut-off value for WHtR in both sexes. High BMI, WC and WHtR were all associated with the prevalence of glucose tolerance abnormalities, with the highest prevalence ratio (PR) for high WHtR (men: PR = 2·85, 95 % CI 2·54, 3·21; women: PR = 3·10, 95 % CI 2·74, 3·51). When combining BMI and WHtR, in men either a high BMI or a high WHtR alone was associated with increased risk. Among women, a high BMI without a concomitant high WHtR was not associated with increased glucose tolerance abnormalities risk, whereas a high WHtR was associated with risk irrespective of BMI.

Among the Chinese adult population measures of central obesity are better predictors of glucose tolerance abnormalities prevalence than BMI. A WHtR cut-off point of 0·5 for both men and women can be considered as optimum for predicting (pre-) diabetes and may be a useful tool for screening and health education.