Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada

Mark Daniel, Stephen A. Marion, Samuel B. Sheps, Clyde Hertzman, Diane Gamble

Research output: Contribution to journalArticle

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Abstract

Background: It is unclear whether obesity and age modify or confound relations between abdominal adiposity and metabolic risk factors for type 2 diabetes. ObJective: Our objective was assess the consistency of relations between abdominal adiposity and glycemic variables across discrete categories of obesity and age. Design: We performed a stratified analysis of prevalence data from a rural screening initiative in British Columbia, Canada. Subjects were Salishan Indians, all healthy relatives of individuals with type 2 diabetes [n = 151; age: 18-80 y; body mass index (BMI, in kg/m2): 17.0- 48.2]. We measured waist-to-hip ratio (WHR) (2 categories); insulin, glycated hemoglobin (Hb A(1c)), and 2-h glucose concentrations (2 categories); and BMI (4 categories). BMI and age-specific odds ratios (ORs) and 95% CIs were calculated. Results: WHR-glycemic variable relations were not consistent across BMI and age strata. Risks associated with high WHR were: for persons with BMIs from 25 to 29, elevated insulin (OR: 6.71; 95% CI: 1.41, 34.11) and Hb A(1c) (OR: 16.23; 95% CI: 2.04, 101.73) concentrations; for persons aged 18-34 y, elevated insulin concentrations [OR: indeterminate (+∞); 95% CI: 1.89, +∞]; and, for persons aged 35-49 y, elevated Hb A(1c) (OR: +∞; 95% CI: 3.17, +∞) and 2-h glucose (OR: 9.15; 95% CI: 1.74, 59.91) concentrations. Conclusions: WHR discriminates risk of type 2 diabetes in overweight but not obese individuals. Abdominal adiposity is associated with elevated insulin concentrations in younger age groups and with impaired glucose control in middle-aged groups, suggesting metabolic staging by age on a continuum from insulin resistance to impaired glucose tolerance.

Original languageEnglish
Pages (from-to)455-460
Number of pages6
JournalAmerican Journal of Clinical Nutrition
Volume69
Issue number3
Publication statusPublished - Mar 1999
Externally publishedYes

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British Columbia
Waist-Hip Ratio
Type 2 Diabetes Mellitus
Canada
Body Mass Index
Odds Ratio
Adiposity
Insulin
Glucose
Obesity
Glucose Intolerance
Glycosylated Hemoglobin A
Insulin Resistance
Age Groups

Cite this

@article{840c6f8869a14e7ba25c7fbf1faaa442,
title = "Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada",
abstract = "Background: It is unclear whether obesity and age modify or confound relations between abdominal adiposity and metabolic risk factors for type 2 diabetes. ObJective: Our objective was assess the consistency of relations between abdominal adiposity and glycemic variables across discrete categories of obesity and age. Design: We performed a stratified analysis of prevalence data from a rural screening initiative in British Columbia, Canada. Subjects were Salishan Indians, all healthy relatives of individuals with type 2 diabetes [n = 151; age: 18-80 y; body mass index (BMI, in kg/m2): 17.0- 48.2]. We measured waist-to-hip ratio (WHR) (2 categories); insulin, glycated hemoglobin (Hb A(1c)), and 2-h glucose concentrations (2 categories); and BMI (4 categories). BMI and age-specific odds ratios (ORs) and 95{\%} CIs were calculated. Results: WHR-glycemic variable relations were not consistent across BMI and age strata. Risks associated with high WHR were: for persons with BMIs from 25 to 29, elevated insulin (OR: 6.71; 95{\%} CI: 1.41, 34.11) and Hb A(1c) (OR: 16.23; 95{\%} CI: 2.04, 101.73) concentrations; for persons aged 18-34 y, elevated insulin concentrations [OR: indeterminate (+∞); 95{\%} CI: 1.89, +∞]; and, for persons aged 35-49 y, elevated Hb A(1c) (OR: +∞; 95{\%} CI: 3.17, +∞) and 2-h glucose (OR: 9.15; 95{\%} CI: 1.74, 59.91) concentrations. Conclusions: WHR discriminates risk of type 2 diabetes in overweight but not obese individuals. Abdominal adiposity is associated with elevated insulin concentrations in younger age groups and with impaired glucose control in middle-aged groups, suggesting metabolic staging by age on a continuum from insulin resistance to impaired glucose tolerance.",
keywords = "Abdominal adiposity, Body fat distribution, Body mass index, North American Indians, Obesity, Type 2 diabetes, Waist-to-hip ratio",
author = "Mark Daniel and Marion, {Stephen A.} and Sheps, {Samuel B.} and Clyde Hertzman and Diane Gamble",
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volume = "69",
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Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada. / Daniel, Mark; Marion, Stephen A.; Sheps, Samuel B.; Hertzman, Clyde; Gamble, Diane.

In: American Journal of Clinical Nutrition, Vol. 69, No. 3, 03.1999, p. 455-460.

Research output: Contribution to journalArticle

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T1 - Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada

AU - Daniel, Mark

AU - Marion, Stephen A.

AU - Sheps, Samuel B.

AU - Hertzman, Clyde

AU - Gamble, Diane

PY - 1999/3

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AB - Background: It is unclear whether obesity and age modify or confound relations between abdominal adiposity and metabolic risk factors for type 2 diabetes. ObJective: Our objective was assess the consistency of relations between abdominal adiposity and glycemic variables across discrete categories of obesity and age. Design: We performed a stratified analysis of prevalence data from a rural screening initiative in British Columbia, Canada. Subjects were Salishan Indians, all healthy relatives of individuals with type 2 diabetes [n = 151; age: 18-80 y; body mass index (BMI, in kg/m2): 17.0- 48.2]. We measured waist-to-hip ratio (WHR) (2 categories); insulin, glycated hemoglobin (Hb A(1c)), and 2-h glucose concentrations (2 categories); and BMI (4 categories). BMI and age-specific odds ratios (ORs) and 95% CIs were calculated. Results: WHR-glycemic variable relations were not consistent across BMI and age strata. Risks associated with high WHR were: for persons with BMIs from 25 to 29, elevated insulin (OR: 6.71; 95% CI: 1.41, 34.11) and Hb A(1c) (OR: 16.23; 95% CI: 2.04, 101.73) concentrations; for persons aged 18-34 y, elevated insulin concentrations [OR: indeterminate (+∞); 95% CI: 1.89, +∞]; and, for persons aged 35-49 y, elevated Hb A(1c) (OR: +∞; 95% CI: 3.17, +∞) and 2-h glucose (OR: 9.15; 95% CI: 1.74, 59.91) concentrations. Conclusions: WHR discriminates risk of type 2 diabetes in overweight but not obese individuals. Abdominal adiposity is associated with elevated insulin concentrations in younger age groups and with impaired glucose control in middle-aged groups, suggesting metabolic staging by age on a continuum from insulin resistance to impaired glucose tolerance.

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KW - Body fat distribution

KW - Body mass index

KW - North American Indians

KW - Obesity

KW - Type 2 diabetes

KW - Waist-to-hip ratio

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