title: Narrow hips and broad waist circumferences independently contribute to increased risk of non-insulin-dependent diabetes mellitus.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  A cross-sectional population-based case-control study.
  
  
  METHODS
  General population.
  
  
  METHODS
  
  
  
  METHODS
  5887 men and 7018 women, aged 20-59 years, without known diabetes or hyperglycaemia.
  
  
  METHODS
  93 men and 66 women were diagnosed with NIDDM.
  
  
  METHODS
  We predicted waist and hips' circumference from the body mass index, weight/height2, (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.
authors.affiliation: Department for Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. j.seidell@RIVM.NL
authors.forename: J C
authors.initials: JC
authors.lastname: Seidell
authors.forename: T S
authors.initials: TS
authors.lastname: Han
authors.forename: E J
authors.initials: EJ
authors.lastname: Feskens
authors.forename: M E
authors.initials: ME
authors.lastname: Lean
mesh_terms: D000005:Abdomen; D000273:Adipose Tissue; D000328:Adult; D001824:Body Constitution; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004198:Disease Susceptibility; D005260:Female; D006615:Hip; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012306:Risk; D012307:Risk Factors; D012885:Skinfold Thickness