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- Title
Abdominal obesity predicts declining insulin sensitivity in non-obese normoglycaemics: the Insulin Resistance Atherosclerosis Study (IRAS).
- Authors
Karter, A. J.; D'Agostino, R. B.; Mayer-Davis, E. J.; Wagenknecht, L. E.; Hanley, A. J. G.; Hamman, R. F.; Bergman, R.; Saad, M. F.; Haffner, S. M.
- Abstract
Cross-sectional studies have demonstrated a relationship between obesity and insulin sensitivity (SI); however, there is a lack of evidence from longitudinal studies.The Insulin Resistance Atherosclerosis Study (IRAS) estimated SI (×10−4/min·µU/ml) directly using a frequently sampled intravenous glucose tolerance test with minimal model analysis in 504 normoglycaemic subjects. Partial correlation coefficients (r) were calculated to compare the relationship of change in SI from baseline to 5 years later (ΔSI) with baseline waist circumference (waist) as a measure of abdominal obesity and body mass index (BMI) as a measure of overall obesity. MeanΔSI was−1.06 (SD = 1.85).Higher baseline waist (r = −0.16; p = 0.0005), but not BMI (r = −0.005; p = 0.91), was associated with (–)ΔSI in models including sex, ethnicity, clinical centre and baseline SI, BMI, waist, age and physical activity. The waist–ΔSI relationship differed across the levels of baseline BMI, being significant only in normal weight (r = −0.21) and overweight subjects (r = −0.16), but not in obese subjects.ΔSI was correlated with a 5-year change in either obesity measure (Δwaist: r = −0.22 andΔBMI: r = −0.20; p = 0.0001).Among non-diabetics, waist circumference was a strong predictor of declining SI among lean subjects, a modest predictor among overweight subjects, but was not predictive among obese individuals. Waist circumference should be considered, in addition to BMI, when identifying individuals at high risk of diabetes or the insulin resistance syndrome.
- Subjects
OBESITY; INSULIN; PANCREATIC secretions; DRUG resistance; INSULIN antibodies; GLUCOSE tolerance tests; BLOOD testing; CARBOHYDRATE intolerance
- Publication
Diabetes, Obesity & Metabolism, 2005, Vol 7, Issue 3, p230
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/j.1463-1326.2004.00441.x