title: Hypertriglyceridemic waist phenotype is associated with decreased insulin sensitivity and incident diabetes in elderly men.
abstract: OBJECTIVE
  To investigate the association between hypertriglyceridemic waist (HTGW) and insulin sensitivity (assessed by euglycemic clamp method), and the development of diabetes in a longitudinal community-based cohort of elderly men without diabetes at baseline.
  
  
  METHODS
  The present cross-sectional study comprised 1,026, 70-year-old men without diabetes. The gold standard euglycaemic-hyperinsulinaemic clamp technique was used. Six-year follow-up on diabetes status were available in n = 667. The HTGW phenotype was defined as having waist circumference ≥ 90 cm, and triglycerides ≥ 2 mmol L⁻¹. The men were stratified into those having normal WC and TG (n = 299), one HTGW component (n = 606), and HTGW (n = 121).
  
  
  RESULTS
  The association between insulin sensitivity and one HTGW component as well as HTGW was highly significant (P < 0.001) in the whole sample, as well as in individuals with high/low BMI (stratified at ≥25). In longitudinal analyses, participants with HTGW was associated with a more than fourfold increased risk for diabetes (Odds ratio 4.64, 95% CI 1.61-13.4, P = 0.004) compared to those with normal WC and TG.
  
  
  CONCLUSIONS
  The present study both confirm and extend previous research suggesting that the HTGW-phenotype portrays an increased glucometabolic risk, also in lean individuals.
authors.affiliation: Center for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Public Health and Caring Sciences/Section of Geriatrics Uppsala University, Uppsala, Sweden.
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
authors.forename: Johan
authors.initials: J
authors.lastname: Ärnlöv
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications / Q000209:etiology*; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D009765:Obesity / Q000150:complications; D056128:Obesity, Abdominal / Q000150:complications*; D050177:Overweight / Q000150:complications; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D014280:Triglycerides