Anthropometric measures and glucose levels in a large multi-ethnic cohort of individuals at risk of developing type 2 diabetes

Koning, Lawrence de; Gerstein, Hertzel C.; Bosch, Jackie; Dı́az, Rafael; Mohan, Viswanathan; Gr, Dagenais; Yusuf, Salim; Anand, Sonia S.

doi:10.1007/s00125-010-1710-3

Cited by 31 publications

(27 citation statements)

References 33 publications

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“…Among these, DM2 boasts the largest body of cross-sectional and longitudinal reports, fundamentally directed to the comparison of various anthropometric indices in regards to prediction of this disease [17]. Our findings support the close relationship between obesity and dysglycemic states: Anthropometric measures increased progressively across glycemic states, similar to the results of Koning et al [18] in over 22,000 individuals from the EpiDream study. Comparison of the 3 anthropometric parameters in regards to detection of DM2 revealed WHR and WC to have the greatest predictive capacity in both men and women, surpassing BMI in sensitivity and specificity.…”

Section: Discussionsupporting

confidence: 90%

Diabetes and Impaired Fasting Glucose Prediction Using Anthropometric Indices in Adults from Maracaibo City, Venezuela

et al. 2016

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To determine the predictive power of various anthropometric indices for the identification of dysglycemic states in Maracaibo, Venezuela. A cross-sectional study with randomized, multi-staged sampling was realized in 2230 adult subjects of both genders who had their body mass index (BMI), waist circumference (WC) and waist-height ratio (WHR) determined. Diagnoses of type 2 diabetes mellitus (DM2) and impaired fasting glucose (IFG) were made following ADA 2015 criteria. ROC curves were used to evaluate the predictive power of each anthropometric parameter. Area under the curve (AUC) values were compared through Delong's test. Of the total 2230 individuals (52.6 % females), 8.4 % were found to have DM2, and 19.5 % had IFG. Anthropometric parameters displayed greater predictive power regarding newly diagnosed diabetics, where WHR was the most important predictor in both females (AUC = 0.808; CI 95 % 0.715-0.900. Sensitivity: 82.8 %; specificity: 76.2 %) and males (AUC = 0.809; CI 95 % 0.736-0.882. Sensitivity: 78.6 %; specificity: 68.1 %), although all three parameters appeared to have comparable predictive power in this subset. In previously diagnosed diabetic subjects, WHR was superior to both WC and BMI in females, and WHR and WC were both superior to BMI in males. Lower predictive values were found for IFG in both genders. Accumulation of various altered anthropometric measurements was associated with increased odds ratios for both newly and previously diagnosed DM2. The predictive power of anthropometric measurements was greater for DM2 than IFG. We suggest assessment of as many available parameters as possible in the clinical setting.

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Section: Discussionsupporting

confidence: 90%

Diabetes and Impaired Fasting Glucose Prediction Using Anthropometric Indices in Adults from Maracaibo City, Venezuela

et al. 2016

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“…On the one hand, Chowdhury et al , 43 in their study of Indian and Swedish men of the same age and BMI, found higher glucose levels in the South Asian men were due to differences in lower leg muscle mass rather than differences in visceral fat, potentially suggesting that physiological differences between ethnic groups may lead to different effects of hip circumference on mortality risk. On the other hand, a powerful confounding effect of hip circumference on the relationship of waist circumference with glucose was observed in the multi-ethnic EpiDREAM study [including Europid (53%), African (6.5%), Latin American (8.1%), South Asian (20.3%) and indigenous (12.1%) participants], which is suggestive of a similar effect in populations other than the South Asian and African populations included here 40 . Further studies including both waist and hip circumference in different population groups and with different outcomes are clearly required 26 …”

Section: Discussionsupporting

confidence: 64%

“…Canoy et al ., 21 in their report on the effects of body fat on risk of coronary heart disease in the European Prospective Investigation of Cancer-Norfolk study, noted that ‘adjustment for hip circumference increased the risk prediction afforded by using waist circumference alone by ≈10% to ≈18% in men and women’ 21 . Likewise, in the large and multi-ethnic Epidemiological arm of the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial (EpiDREAM) cohort, De Koning et al 40 . observed that the true effect of waist circumference on glucose levels only became apparent after adjustment for both waist and hip circumferences.…”

Section: Discussionmentioning

confidence: 99%

The influence of hip circumference on the relationship between abdominal obesity and mortality

Cameron

Magliano

Shaw

et al. 2012

International Journal of Epidemiology

102

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Background Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction.Methods In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated.Results Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored.Conclusions The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models.

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“…Both waist:hip ratio (WHR) and BMI have previously been shown to be strong predictors of type 2 diabetes [21,22]. Systolic and diastolic blood pressure was the average of two measurements in the sitting position using an automatic sphygmomanometer (Spengler SP9).…”

Section: Baseline Data Collectionmentioning

confidence: 99%

The relationship between adipokines and the onset of type 2 diabetes in middle-aged men: The PRIME study

Neville

Patterson

Linden

et al. 2016

Diabetes Research and Clinical Practice

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Woodside, J. V. (2016). The relationship between adipokines and the onset of type 2 diabetes in middle-aged men: The PRIME study. Diabetes Research and Clinical Practice, 120,[24][25][26][27][28][29][30] Publisher rights © 2016 Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/bync-nd/4.0/which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited. General rightsCopyright for the publications made accessible via the Queen's University Belfast Research Portal is retained by the author(s) and / or other copyright owners and it is a condition of accessing these publications that users recognise and abide by the legal requirements associated with these rights.Take down policy The Research Portal is Queen's institutional repository that provides access to Queen's research output. Every effort has been made to ensure that content in the Research Portal does not infringe any person's rights, or applicable UK laws. If you discover content in the Research Portal that you believe breaches copyright or violates any law, please contact openaccess@qub.ac.uk. Abstract:Aims: Epidemiological evidence suggests that adipokines may be associated with the onset of type 2 diabetes, but the evidence to date is limited and inconclusive. This study examined the association between adiponectin and leptin and the subsequent diagnosis of type 2 diabetes in a UK population based cohort of non-diabetic middle-aged men.Methods: Baseline serum levels of leptin and adiponectin were measured in 1839 nondiabetic men aged 50-60 years who were participating in the prospective population-based PRIME study. Over a mean follow-up of 14.7 years, new cases of type 2 diabetes were determined from self-reported clinical information with subsequent validation by general practitioners.Results: 151 participants developed type 2 diabetes during follow-up. In Cox regression models adjusted for age, men in the top third of the leptin distribution were at increased risk (hazard ratio (HR) 4.27, 95%CI 2.67-6.83) and men in the top third of the adiponectin distribution at reduced risk (HR 0.24, 95%CI 0.14-0.42) relative to men in the bottom third.However, significance was lost for leptin after additional adjustment for BMI, waist to hip ratio, lifestyle factors and biological risk factors, including C-reactive protein (CRP). Further adjustment for HOMA-IR also resulted in loss of significance for adiponectin. Conclusions:This study provides evidence that adipokines are associated with men's future type 2 diabetes risk but not independently of other risk factors.

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Anthropometric measures and glucose levels in a large multi-ethnic cohort of individuals at risk of developing type 2 diabetes

Cited by 31 publications

References 33 publications

Diabetes and Impaired Fasting Glucose Prediction Using Anthropometric Indices in Adults from Maracaibo City, Venezuela

Diabetes and Impaired Fasting Glucose Prediction Using Anthropometric Indices in Adults from Maracaibo City, Venezuela

The influence of hip circumference on the relationship between abdominal obesity and mortality

The relationship between adipokines and the onset of type 2 diabetes in middle-aged men: The PRIME study

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