title: Abdominal obesity and insulin resistance in patients with type 2 diabetes in a Swedish community. Skaraborg hypertension and diabetes project.
abstract: OBJECTIVE
  To explore the association between abdominal obesity and insulin resistance in patients with type 2 diabetes.
  
  
  METHODS
  A cross-sectional observational study.
  
  
  METHODS
  Primary care in Skara, Sweden.
  
  
  METHODS
  A total of 198 men and 186 women with type 2 diabetes who consecutively completed an annual check-up in 1992-1993.
  
  
  METHODS
  Abdominal obesity was defined according to criteria for the metabolic syndrome using the waist circumference (WC): > 102 cm for men and > 88 cm for women. Insulin resistance was estimated using the Homeostasis Model Assessment (HOMA), and was dichotomized by the 75th percentile (IR).
  
  
  RESULTS
  Abdominal obesity was found in 66 men (33%), and in 106 women (57%). Pearson's correlation coefficients between components of the metabolic syndrome and IR were statistically significant for WC, waist-hip ratio, serum triglycerides, and HDL cholesterol, and were higher for WC (0.40) than for waist-hip ratio (0.23) in both genders (p < 0.001). The association between WC and IR was challenged by successively entering other components of the metabolic syndrome into the model in a logistic regression. In the final model, adjusting for differences in age, systolic blood pressure, HbA1c, serum triglycerides, HDL cholesterol, and microalbuminuria, the association remained statistically significant both in men (OR 8.6, 95% CI 3.0-25.2, p < 0.001), and in women (OR 5.6, 95% CI 1.7-18.1, p = 0.004).
  
  
  CONCLUSIONS
  WC provides a feasible measure for insulin resistance in the vast majority of subjects with type 2 diabetes. It is convenient and less expensive than direct means and could be used as a proxy for insulin resistance in population studies.
authors.affiliation: Department of Clinical Sciences, Malmö, Lund University, Skövde, Sweden.
authors.forename: Muhammad Rizuanul
authors.initials: MR
authors.lastname: Bari
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Ostgren
authors.forename: Lennart
authors.initials: L
authors.lastname: Råstam
authors.forename: Ulf
authors.initials: U
authors.lastname: Lindblad
mesh_terms: D050153:Abdominal Fat; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications*; D049629:Waist-Hip Ratio