Objective This study investigated the application value of waist-to-height ratio (WHtR), body mass index (BMI), and waist-to-hip ratio (WHR) in screening for type 2 diabetes mellitus (T2DM) and high risk of T2DM. Methods A total of 7 582 subjects aged 40-75 years were randomly selected and stratified based on the results of an oral glucose tolerance test (OGTT) administered during a standard screening for T2DM in the Shougang community.Three anthropometric indices(WHtR,BMI,and WHR) were compared, with the optimal cutoffs for WHtR, BMI, and WHR identified using receiver operating characteristic curve (ROC) analysis. Using multivariate logistic regression analysis and the area under the curve(AUC)of ROC,the associations between BMI,WHR,and WHtR and T2DM were analyzed by group: normal glucose tolerance group (n= 3 080), T2DM high-risk group (n= 2 992 cases), and T2DM group(n=1 510).Results Logistic regression analysis showed that BMI,WHR,WHtR,and family history of diabetes were positively correlated with T2DM and high risk of T2DM(P<0.05 and P<0.01,respectively);WHtR was most significant, with odds ratios of 90.409 and 69.285, respectively. WHtR had the greatest AUC under the ROC in men,whereas BMI had the greatest AUC in women.The optimal cutoffs values for the detection of T2DM were 0.51, 25.47 kg/m2, and 0.91 for WHtR, BMI, and WHR in men, respectively, and 0.52, 24.95 kg/m2, and 0.86 for WHtR, BMI, and WHR in women, respectively. WHtR was more efficient than WHR and BMI based on the AUC. The optimal cutoff values for detecting a high risk for T2DM were 0.51,25.30 kg/m2,and 0.91 for WHtR,BMI,and WHR in men and 0.51,24.81 kg/m2,and 0.86 for WHtR, BMI, and WHR in women, respectively. Conclusion Waist-to-height ratio may be a more effective index for diagnosing type 2 diabetes mellitus and identifying individuals at high risk for T2DM than BMI or WHR.