title: Determining the waist circumference in african americans which best predicts insulin resistance.
abstract: Total body size and central fat distribution are important determinants of insulin resistance. The BMI and waist circumference (WC) thresholds in African Americans that best predict insulin resistance are unknown. Our goal was to determine the BMI and WC values in African Americans, which optimally predict insulin resistance. The subjects were African Americans (68 men, 63 women), aged 35 +/- 8 years (mean +/- s.d.), with a BMI of 30.9 +/- 7.5, in the range of 18.5-54.7 kg/m(2), and with a WC of 98 +/- 18, in the range of 69-173 cm. Insulin resistance was defined by the lowest tertile of the insulin sensitivity index (S(I)). The Youden index was calculated to determine the WC and BMI thresholds that predict insulin resistance with an optimal combination of sensitivity and specificity. In men the thresholds that optimally predicted insulin resistance were a BMI > or =30 kg/m(2) or a WC > or =102 cm. For women, insulin resistance was best predicted by a BMI > or =32 kg/m(2) or a WC > or =98 cm. In African Americans, insulin resistance (in men) was best predicted by a WC > or =102 cm, and in women by a WC > or =98 cm, or by a BMI value that fell in the obese category (men: > or =30 kg/m(2), women: > or =32 kg/m(2)).
authors.affiliation: Clinical Endocrinology Branch, NIDDK, Bethesda, Maryland, USA. jhjelmborg@health.sdu.dk
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sumner
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Sen
authors.forename: Madia
authors.initials: M
authors.lastname: Ricks
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Frempong
authors.forename: Nancy G
authors.initials: NG
authors.lastname: Sebring
authors.forename: Harvey
authors.initials: H
authors.lastname: Kushner
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000208:ethnology*; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000208:ethnology*; D050177:Overweight / Q000175:diagnosis / Q000208:ethnology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D049629:Waist-Hip Ratio