Narrow hips and broad waist circumferences independently contribute to increased risk of non‐insulin‐dependent diabetes mellitus

Abstract

Abstract. Seidell JC, Han TS, Feskens EJM, Lean MEJ (National Institute of Public Health and the Environment, Bilthoven, the Netherlands, and Royal Infirmary, University of Glasgow, Glasgow, UK). Narrow hips and broad waist circumferences independently contribute to increased risk of noninsulin-dependent diabetes mellitus. J Intern Med 1997; 242: 401-406.Objectives. Patients with non-insulin-dependent diabetes mellitus (NIDDM) have been shown to be more obese and have higher waist-to-hips circumference ratios compared to nondiabetics. In this study, we tried to dissociate obesity, waist and hip circumference from NIDDM. Design. A cross-sectional population-based casecontrol study. Setting. General population. Subjects. Controls: 5887 men and 7018 women, aged 20-59 years, without known diabetes or hyperglycaemia. Cases: 93 men and 66 women were diagnosed with NIDDM. Main outcome measures. We predicted waist and hips' circumference from the body mass index, weight/height 2 , (BMI) on the basis of linear regression. Differences between observed and expected values (residuals) of waist and hip circumference were categorized into tertiles. The relative odds of having NIDDM in tertiles of waist and hip residuals (middle tertile as reference) were calculated by multiple logistic regression analysis adjusted for each other and for age, smoking, physical activity, alcohol consumption and education. Results. NIDDM was most prevalent in men and women who had larger waists and in those who had smaller hip circumferences than expected from their BMI. Adjusted odds ratios (95% CI) for NIDDM were 2.9 (1.6-5.1) in men and 2.8 (1.5-5.1) in women who had a larger than expected waist, and were 3.7 (2.1-6.5) in men and 2.1 (1.1-3.8) in women who had smaller than expected hips. Conclusions. Our findings suggest that diabetics have larger waists and smaller hips compared to nondiabetics, irrespective of their degree of obesity, age and life-style factors. One possibility is that besides abdominal fatness, peripheral muscle atrophy is one of the factors associated with NIDDM.

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

“…Thus, the women in India have a larger waist and smaller hips than expected for their BMI. Given the higher insulin levels in women in India, it is interesting that a large European study has shown that narrow hips and broad waist for a given BMI contribute to increased risk of NIDDM (Seidell et al, 1997). An excess of abdominal fat has been noted in other groups of Asian women, while still of relatively low BMI, for example, women in China showed a tendency to a central pattern of fat distribution (mean WHR¼0.8), while mean BMI was only 20.1-21.9 (Folsom et al, 1994).…”

Waist circumference, body mass index, hip circumference and waist-to-hip ratio as predictors of cardiovascular disease in Aboriginal people

“…Large hip circumference is found to be associated with a lower risk of diabetes, independent of BMI and WC (Seidell et al, 1997;Snijder et al, 2003).…”

“…Lean et al (1995) proposed WC as a simple measurement to indicate the need for weight management. Several studies found a close relation between WC and cardiovascular risk factors Seidell et al, 1997;Janssen et al, 2002). The Framingham study suggested that the waist predicted mortality better than other anthropometric measures (Higgins et al, 1988).…”

Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors

“…First, like FFM, hip or thigh, circumferences have been shown to be inversely associated with health risk. 39,[49][50][51][52][53][54] A greater lean mass in the nonabdominal region (i.e. a higher muscle mass in the gluteofemoral region) may explain the protective effect of a large hip or thigh circumference.…”