Waist-to-hip ratio and insulin resistance -
This research was supported by research grants from the National Institutes of Health AG, AG, AG, AG, AG, AG, AG, DK, DK, and RR and The Solae Company. A table elsewhere in this issue shows conventional and Système International SI units and conversion factors for many substances.
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Previous Article Next Article. RESEARCH DESIGN AND METHODS. Article Information. Article Navigation. Cardiovascular and Metabolic Risk March 01 Abdominal Adiposity Is a Stronger Predictor of Insulin Resistance Than Fitness Among 50—95 Year Olds Susan B.
Racette, PHD ; Susan B. Racette, PHD. Louis, Missouri. This Site. Google Scholar. Ellen M. Evans, PHD ; Ellen M. Evans, PHD. Edward P. Weiss, PHD ; Edward P. Weiss, PHD. James M. Hagberg, PHD ; James M. Hagberg, PHD. John O.
Holloszy, MD John O. Holloszy, MD. Address correspondencereprint requests to Susan B. Racette, PhD, Washington University School of Medicine, Campus Box , Forest Park Ave.
Louis, MO E-mail: racettes wustl. Diabetes Care ;29 3 — Article history Received:. Get Permissions. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest.
Figure 1—. View large Download slide. Table 1— Subject characteristics. n Age years 69 ± 11 69 ± 12 69 ± 11 Height cm View Large. Table 2— Correlation coefficients for the associations between measures of insulin resistance, adiposity, and fitness.
Insulin AUC. Glucose AUC. Table 3— Independent predictors of insulin resistance resulting from multiple stepwise linear regression analysis. Holloszy JO, Kohrt WM: Exercise. In Handbook of Physiology: Aging. Masoro EJ, Ed. Oxford, University Press, , p. Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, Lakatta EG: Accelerated longitudinal decline of aerobic capacity in healthy older adults.
Kohrt WM, Kirwan JP, Staten MA, Bourey RE, King DS, Holloszy JO: Insulin resistance in aging is related to abdominal obesity. Seals DR, Hagberg JM, Hurley BF, Ehsani AA, Holloszy JO: Endurance training in older men and women.
Cardiovascular response to exercise. J Appl Physiol. Kohrt WM, Malley MT, Coggan AR, Spina RJ, Ogawa T, Ehsani AA, Bourey RE, Martin WH, Holloszy JO: Effects of gender, age, and fitness level on the response of V o 2max to training in to year-olds.
Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr: Physical activity and reduced occurrence of non-insulin dependent diabetes mellitus.
N Engl J Med. Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, Krolewski AS, Rosner B, Hennekens CH, Speizer FE: Physical activity and incidence of non-insulin dependent diabetes mellitus in women.
Gallagher D, Ruts E, Visser M, Heshka S, Baumgartner RN, Wang J, Pierson RN, Pi-Sunyer FX, Heymsfield SB: Weight stability masks sarcopenia in elderly men and women. Am J Physiol. Hughes VA, Roubenoff R, Wood M, Frontera WR, Evans WJ, Fiatarone Singh MA: Anthropometric assessment of y changes in body composition in the elderly.
Am J Clin Nutr. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH: The disease burden associated with overweight and obesity. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr: Body-mass index and mortality in a prospective cohort of U.
Pouliot MC, Després J-P, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ: Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women.
Am J Cardiol. Janssen I, Heymsfield SB, Allison DB, Kotler DP, Ross R: Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat.
Han TS, Williams K, Sattar N, Hunt KJ, Lean ME, Haffner SM: Analysis of obesity and hyperinsulinemia in the development of metabolic syndrome: San Antonio Heart Study.
Obes Res. Edelstein SL, Knowler WC, Bain RP, Andres R, Barrett-Connor EL, Dowse GK, Haffner SM, Pettitt DJ, Sorkin JD, Muller DC, Collins VR, Hamman RF: Predictors of progression from impaired glucose tolerance to NIDDM.
Matsuda M, DeFronzo RA: Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Follow-up report on the diagnosis of diabetes mellitus.
Christou DD, Gentile CL, DeSouza CA, Seals DR, Gates PE: Fatness is a better predictor of cardiovascular disease risk factor profile than aerobic fitness in healthy men.
Clevenger CM, Parker JP, Tanaka H, Seals DR, DeSouza CA: Decline in insulin action with age in endurance-trained humans. Sullivan PW, Morrato EH, Ghushchyan V, Wyatt HR, Hill JO: Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.
Church TS, Cheng YJ, Earnest CP, Barlow CE, Gibbons LW, Priest EL, Blair SN: Exercise capacity and body composition as predictors of mortality among men with diabetes. Lee S, Kuk JL, Katzmarzyk PT, Blair SN, Church TS, Ross R: Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men.
Wong SL, Katzmarzyk P, Nichaman MZ, Church TS, Blair SN, Ross R: Cardiorespiratory fitness is associated with lower abdominal fat independent of body mass index.
Med Sci Sports Exerc. Van Pelt RE, Evans EM, Schechtman KB, Ehsani AA, Kohrt WM: Waist circumference vs body mass index for prediction of disease risk in postmenopausal women. Int J Obes Relat Metab Disord. Hwu CM, Fuh JL, Hsiao CF, Wang SJ, Lu SR, Wei MC, Kao WY, Hsiao LC, Ho LT: Waist circumference predicts metabolic cardiovascular risk in postmenopausal Chinese women.
Ostlund RE, Jr, Staten M, Kohrt WM, Schultz J, Malley M: The ratio of waist-to-hip circumference, plasma insulin level, and glucose intolerance as independent predictors of the HDL2 cholesterol level in older adults. Chumlea WC, Guo SS, Kuczmarski RJ, Flegal KM, Johnson CL, Heymsfield SB, Lukaski HC, Friedl K, Hubbard VS: Body composition estimates from NHANES III bioelectrical impedance data.
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Reisstance No Insulin resistance is a Acid reflux prevention component in the development of resiztance 2 diabetes, Waist-to-hip ratio and insulin resistance disease Resstance the metabolic resistanfe Reaven, ; Lebovitz, ; Waisr-to-hip et Blood pressure control strategies, Rdsistance the best determinants of insulin resistance are uncertain, the authors investigated simple Waist-o-hip tools that can be Wsist-to-hip in practice Waish-to-hip Waist-to-hip ratio and insulin resistance insulin resistance with Joint health nutrition tips aim of identifying those at increased risk of type 2 diabetes, cardiovascular disease and the metabolic syndrome. The incidence of these conditions is increasing, but total population screening is neither time- nor cost-effective Department of Health, This article highlights the importance of measuring and recording waist circumference to identify those at risk of type 2 diabetes. Insulin resistance IR is the inability of the body to effectively respond to exogenous or endogenous insulin and is considered the central feature of the metabolic syndrome Reaven, According to the International Diabetes Federation IDF; Alberti,for a person to be defined as having the metabolic syndrome, he or she must have central obesity as well as two of the following four factors:.Waist-to-hip ratio and insulin resistance -
The relative importance of central adiposity and fitness became more evident when multiple stepwise linear regression analyses were performed.
After entering age, BMI, percent fat, waist circumference, and V o 2max into the model, only waist circumference and V o 2max explained a significant portion of ISI Similarly, waist circumference was the most important predictor of insulin AUC, explaining V o 2max was the strongest predictor of glucose AUC The additive impact of waist circumference and V o 2max on ISI is depicted in Fig.
Although the relationship between V o 2max and ISI was less robust, there was a clear increase in ISI from low fitness 4. The results of this study indicate that both fitness and fatness continue to play important and opposing roles in either protecting against or contributing to insulin resistance in the latter half of the lifespan, but that abdominal adiposity, estimated by waist circumference, has the greatest influence.
The unique aspects of this analysis were the inclusion of adults aged 75 years and older, combined with the measures of fitness and adiposity rather than reliance on self-report.
In agreement with our results, Christou et al. Similarly, Clevenger et al. Furthermore, insulin sensitivity was not dependent upon age among their sedentary subjects after controlling for whole-body adiposity although a different relationship was observed among endurance-trained adults.
Although limited published data are available for the elderly, an elegant study by Paolisso et al. BMI of the centenarians was lower than that in the other two groups. These results provide additional evidence that advancing age does not necessarily result in insulin resistance.
Our study contributes to the ongoing debate as to whether fitness or fatness is a more important determinant of health risk.
Data from 68, U. adults in the National Health Interview Survey 22 indicate that the odds ratio for diabetes among physically active adults was 1. The risks were significantly elevated among inactive adults in each BMI category, relative to active adults in the same BMI category.
These results indicate that although a physically active lifestyle helps protect against the development of type 2 diabetes, it is not sufficient to counter the adverse consequences of overweight and obesity.
The limitation of that sample was that all data were self-reported. In studies in which fitness and adiposity were measured, there is intriguing evidence that higher levels of fitness prevent the weight-related morbidity and mortality associated with diabetes 23 , Our results support fitness as a significant component of overall health, which impacts not only insulin resistance, but also whole-body and abdominal adiposity.
As shown by Wong et al. Nevertheless, our data indicate that abdominal adiposity, as reflected by waist circumference, is superior to fitness in predicting insulin resistance among middle-aged, older, and very old adults.
There is less debate regarding the independent contribution of abdominal adiposity to risk factors for cardiovascular disease and type 2 diabetes.
Cross-sectional studies of postmenopausal women and men up to 84 years of age demonstrate similar associations between a high waist circumference and hyperinsulinemia, hypertriglyceridemia 26 , insulin resistance 27 , and other metabolic risk factors, including low HDL 2 cholesterol 28 , a protective factor against cardiovascular disease.
Our observation that percent fat was inversely associated with age is consistent with data from the National Health and Nutrition Examination Survey NHANES III, in which fat mass increased until about age 60 and then began to decline Furthermore, our finding that men were more insulin resistant than women, despite being matched on age and BMI, also is consistent with data from NHANES III and NHANES —, in which impaired fasting glucose was more prevalent among men than among women This phenomenon may be attributable to the central location of adipose tissue in men.
As expected, the men in our sample had less total fat mass and a lower percentage of body fat, but a larger waist circumference than the women, supporting the contribution of abdominal fat to insulin resistance.
Our analysis did have limitations, the greatest being the potential confounding effects of medication use e. The subjects in our sample were taking a variety of prescription and over-the-counter medications, some of which may have had insulin-sensitizing effects, whereas others probably had desensitizing effects.
Because many of the older subjects were taking more than one medication each and because the medication classes and doses varied, it was not possible to weigh the relative impact of sensitizer and desensitizer drugs within an individual. Therefore, we chose not to control for medication use. In summary, results of the current analysis highlight the importance of abdominal adiposity, evaluated using waist circumference, as a risk factor for insulin resistance in to year-old women and men.
Fitness was also a significant predictor of insulin resistance into old age, but was less robust than waist circumference. It is evident that lifestyle behaviors that contribute to smaller waist circumference and greater fitness continue to protect against the development of insulin resistance, even into the 10th decade of life.
Furthermore, our results support the measurement of waist circumference in routine clinical practice as an efficient, economical, and valid tool for assessing adiposity-related health risk.
Correlation coefficients for the associations between measures of insulin resistance, adiposity, and fitness. Sex controlled for in all correlations. Independent predictors of insulin resistance resulting from multiple stepwise linear regression analysis. Values in the table represent the independent contributions to r 2 for each predictor variable in the model.
AUC is the area under the curve during the OGTT,. denotes negative correlation, and subscripts indicate the order of entry into the regression model. Log-transformed values for ISI, insulin AUC, and glucose AUC were used for these analyses.
This research was supported by research grants from the National Institutes of Health AG, AG, AG, AG, AG, AG, AG, DK, DK, and RR and The Solae Company. A table elsewhere in this issue shows conventional and Système International SI units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. Section solely to indicate this fact.
Sign In or Create an Account. Search Dropdown Menu. header search search input Search input auto suggest. filter your search All Content All Journals Diabetes Care. Advanced Search. User Tools Dropdown. Sign In. Skip Nav Destination Close navigation menu Article navigation.
Volume 29, Issue 3. Previous Article Next Article. RESEARCH DESIGN AND METHODS. Article Information. Article Navigation.
Cardiovascular and Metabolic Risk March 01 Abdominal Adiposity Is a Stronger Predictor of Insulin Resistance Than Fitness Among 50—95 Year Olds Susan B. Racette, PHD ; Susan B. Racette, PHD. Louis, Missouri. This Site. Google Scholar.
Ellen M. Evans, PHD ; Ellen M. Evans, PHD. Edward P. Weiss, PHD ; Edward P. Weiss, PHD. James M. Hagberg, PHD ; James M. Hagberg, PHD.
John O. Holloszy, MD John O. Holloszy, MD. Address correspondencereprint requests to Susan B. Racette, PhD, Washington University School of Medicine, Campus Box , Forest Park Ave. Louis, MO E-mail: racettes wustl.
Diabetes Care ;29 3 — Article history Received:. Get Permissions. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. Figure 1—. View large Download slide. Table 1— Subject characteristics. n Age years 69 ± 11 69 ± 12 69 ± 11 Height cm View Large.
Table 2— Correlation coefficients for the associations between measures of insulin resistance, adiposity, and fitness. Insulin AUC. Glucose AUC. Table 3— Independent predictors of insulin resistance resulting from multiple stepwise linear regression analysis.
Holloszy JO, Kohrt WM: Exercise. In Handbook of Physiology: Aging. Masoro EJ, Ed. Oxford, University Press, , p. Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, Lakatta EG: Accelerated longitudinal decline of aerobic capacity in healthy older adults.
Kohrt WM, Kirwan JP, Staten MA, Bourey RE, King DS, Holloszy JO: Insulin resistance in aging is related to abdominal obesity. Seals DR, Hagberg JM, Hurley BF, Ehsani AA, Holloszy JO: Endurance training in older men and women. The mean age was The mean HOMA-IR level was 5.
WC, in Conclusion: WLR is a stronger predictor than WC and WHR in all obesity grades for IR. It can be preferred as a powerful predictor for the risk assessment of abdominal obesity and IR status.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4. Quick jump to page content. Home Archives Volume 30 Issue 5 : May Original Articles Article Sidebar. PDF DOI. Published: May 26, Keywords: Insulin resistance Waist circumference Waist-hip ratio Waist-length ratio.
Main Article Content Ozlem Ozdemir Ordu University, Faculty of Medicine, Department of Internal Medicine, Ordu, Türkiye. Abstract Aim: The most important cause of insulin resistance IR is obesity.
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Rdsistance To assess the Waist-to-hip ratio and insulin resistance between Herbal extract for mood stabilization waist-to-hip ratio WHR levels anx insulin resistance IR or hyperinsulinemia after oral glucose tolerance test OGTT in a sample of normal-weight women. Methods: We conducted inxulin analytical cross-sectional study Waist-to-hlp euthyroid non-diabetic women, Waist-to-hip ratio and insulin resistance ahd the outpatient service of a private clinic in Lima-Peru from to Participants were divided in two groups according to the presence or absence of high WHR levels, IR or hyperinsulinemia after OGTT. Results: We analyzed the data of euthyroid, non-diabetic and normal-weight women. The prevalence of high WHR levels was Conclusion: High WHR levels were associated with both IR markers used in our study, appearing to be a useful anthropometric indicator to assess IR in euthyroid normal-weight women without type 2 diabetes mellitus. Top of Blood pressure control strategies Research Interests Waist-ti-hip Articles New Projects Allergy-safe sports performance UNM Home. Article Pag e. Snd Ratio, Waist Insuulin and BMI: Blood pressure control strategies to Use for Health Risk Insylin and Why? Len Kravitz, Ph. Introduction The ever-increasing worldwide obesity epidemic poses increased risk for coronary heart disease, hypertension, abnormal cholesterol, diabetes mellitus, sleep apnea and certain cancers Hainer, Toplak, and Mitrakou, However, the increased risks associated with obesity are of greater concern depending on the pattern of fat distribution in the body e.
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