title: Ratio of waist-to-calf circumference and carotid atherosclerosis in Korean patients with type 2 diabetes.
abstract: OBJECTIVE
  To investigate whether waist circumference (WC), calf circumference (CC), and waist-to-calf ratio (WCR) are associated with carotid atherosclerosis in patients with type 2 diabetes.
  
  
  METHODS
  This was an observational study performed in 3,694 Korean patients with type 2 diabetes. Anthropometric measures and carotid ultrasound were performed on each subject. Carotid atherosclerosis was defined as having a clearly isolated focal plaque or mean carotid intima-media thickness (CIMT) ≥1.1 mm.
  
  
  RESULTS
  CIMT and the frequency of carotid atherosclerosis were higher with increasing WC quartiles and decreasing CC quartiles. There was an augmentative effect of CC and WC on the frequency of carotid atherosclerosis, which was dramatically higher in both the highest WC quartile and lowest CC quartile. However, except for the relationship between the quartile of CC with the frequency of carotid atherosclerosis in men, those associations disappeared after adjusting for potential confounders. In contrast, WCR was significantly related to CIMT (only in women) and carotid atherosclerosis, even after adjustment (adjusted odds ratio for carotid atherosclerosis for the highest quartile of WCR compared with the lowest quartile being 1.178 [95% CI 1.026-1.353] and 1.276 [1.053-1.545] in men and women, respectively).
  
  
  CONCLUSIONS
  A low CC and high WC seems to be associated with a carotid atherosclerotic burden in Korean diabetic patients. In particular, compared with each circumference, WCR is independently associated with carotid atherosclerosis. However, the cross-sectional nature of the study limits conclusions regarding the direction or causality. Further longitudinal study is warranted in this and other ethnic groups.
authors.affiliation: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Kim
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Choi
authors.forename: Byung Wook
authors.initials: BW
authors.lastname: Huh
authors.forename: Chul-Sik
authors.initials: CS
authors.lastname: Kim
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Park
authors.forename: Eun Jig
authors.initials: EJ
authors.lastname: Lee
authors.forename: Yong-Wook
authors.initials: YW
authors.lastname: Cho
authors.forename: Kap Bum
authors.initials: KB
authors.lastname: Huh
mesh_terms: D000368:Aged; D044466:Asian People; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007723:Korea; D007866:Leg / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology*