International Journal of Preventive Medicine (Int J Prev Med)2008-7802002015021714751475EN20150217<strong>Background:</strong> Several measures of adiposity have been used for predicting diabetes. The results of studies regarding superiority of waist circumference&nbsp; (WC) to body mass index&nbsp; (BMI) are <br />inconsistent. This study designed to compare the ability of different anthropometric measures in predicting diabetes and to determine their optimal cut‑off values.<br /><strong>Methods:</strong> A population‑based cross‑sectional study was conducted with 1,000 representative sample among adults aged 20&ndash;80 years in Babol, the Northern Iran. The demographic data were collected in a household survey, and the anthropometric measures of weight, height, waist, and hip circumference were measured with a standard method. Fasting blood sugar (FBS) &ge;126 mg/dl was considered as diabetes. receiver operating characteristic analysis was used to estimate the predictive ability of different anthropometric indexes and their optimal cut‑off values for high FBS.<br /><strong>Results:</strong> The overall prevalence rate of diabetes was 14.0% (14.4% in men vs. 13.5% in women, P = 0.65). The prevalence rate was signifcantly higher in older age (&gt;60 years), low educated and obese&nbsp; (P = 0.001). The mean of BMI, WC, waist‑to‑hip ratio&nbsp; (WHR), and waist‑to‑height ratio&nbsp; (WHtR) <br />were signifcantly higher among diabetic in both sexes (P = 0.001). Among men, WC (area under the ROC curve&nbsp; [AUC] =0.64) and WHtR&nbsp; (AUC = 0.63) have slightly higher accuracy index compared with BMI (AUC = 0.62) or WHR (AUC = 0.60). In contrast, among women, WHtR (AUC = 0.69) and WC (AUC = 0.68) yielded slightly better predictive than BMI (AUC = 0.67). The optimal cut‑off values obtained for BMI and WHtR were similar between two sexes (BMI = 24.95 kg/m2 for men <br />and BMI = 25.2 kg/m2 for women, WHtR = 0.51 for both sexes) whereas the optimal cut‑off value for WC was higher in men than women (98.5 cm men vs. 89.5 cm women).<br /><strong>Conclusions:</strong> Overall WC and WHtR exhibited a slightly better discriminate performance than BMI for diabetes in both sexes, particularly in women.<br /><strong>Keywords:</strong> Body mass index, diabetes, waist circumference, waist‑to‑height ratio, waist‑to‑hip ratiohttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1475http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1475/1753