title: Associations of hip and thigh circumferences independent of waist circumference with the incidence of type 2 diabetes: the Hoorn Study.
abstract: BACKGROUND
  The higher risk of type 2 diabetes in persons with a high waist-to-hip ratio (WHR) or waist-to-thigh ratio (WTR) has mostly been attributed to increased visceral fat accumulation. However, smaller hip or thigh circumference may also explain the predictive value of the WHR or WTR for type 2 diabetes.
  
  
  OBJECTIVE
  This study considered prospectively the association of hip and thigh circumferences, independent of waist circumference, with the incidence of type 2 diabetes.
  
  
  METHODS
  The Hoorn Study is a population-based cohort study of diabetes. A total of 1357 men and women aged 50-75 y and nondiabetic at baseline participated in the 6-y follow-up examination. Glucose tolerance was assessed by use of a 75-g oral-glucose-tolerance test. Baseline anthropometric measurements included body mass index (BMI) and waist, hip, and thigh circumferences.
  
  
  RESULTS
  Logistic regression analyses showed that a 1-SD larger hip circumference gave an odds ratio (OR) for developing diabetes of 0.55 (95% CI: 0.36, 0.85) in men and 0.63 (0.42, 0.94) in women, after adjustment for age, BMI, and waist circumference. The adjusted ORs for a 1-SD larger thigh circumference were 0.79 (0.53, 1.19) in men and 0.64 (0.46, 0.93) in women. In contrast with hip and thigh circumferences, waist circumference was positively associated with the incidence of type 2 diabetes in these models (ORs ranging from 1.60 to 2.66).
  
  
  CONCLUSIONS
  Large hip and thigh circumferences are associated with a lower risk of type 2 diabetes, independently of BMI, age, and waist circumference, whereas a larger waist circumference is associated with a higher risk.
authors.affiliation: Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, Netherlands. mb.snijder.emgo@med.vu.nl
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Piet J
authors.initials: PJ
authors.lastname: Kostense
authors.forename: John S
authors.initials: JS
authors.lastname: Yudkin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Heine
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Seidell
mesh_terms: D000005:Abdomen; D000273:Adipose Tissue / Q000033:anatomy & histology*; D000368:Aged; D001823:Body Composition; D001824:Body Constitution; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006615:Hip / Q000033:anatomy & histology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D013848:Thigh / Q000033:anatomy & histology