title: Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in mexican american families.
abstract: OBJECTIVE
  In spite of the growing recognition of the specific association of waist circumference (WC) with type 2 diabetes (T2D) and insulin resistance (IR), current guidelines still use body mass index (BMI) as a tool of choice. Our objective was to determine whether WC is a better T2D predictor than BMI in family-based settings.
  
  
  METHODS
  Using prospectively collected data on 808 individuals from 42 extended Mexican American families representing 7617.92 person-years follow-up, we examined the performance of WC and BMI as predictors of cumulative and incident risk of T2D. We used robust statistical methods that accounted for the kinships and included polygenic models, discrete trait modeling, Akaike information criterion, odds ratio (OR), relative risk (RR) and Kullback-Leibler R(2). SOLAR software was used to conduct all the data analyses.
  
  
  RESULTS
  We found that in multivariate polygenic models, WC was an independent predictor of cumulative (OR = 2.76, p = 0.0002) and future risk of T2D (RR = 2.15, p = 3.56×10(-9)) and outperformed BMI when compared in a head-to-head fashion. High WC (≥94.65 cm after adjusting for age and sex) was also associated with high fasting glucose, insulin and triglyceride levels and low high-density lipoprotein levels indicating a potential association with IR. Moreover, WC was specifically and significantly associated with insulin resistant T2D (OR = 4.83, p = 1.01×10(-13)).
  
  
  CONCLUSIONS
  Our results demonstrate the value of using WC as a screening tool of choice for future risk of T2D in Mexican American families. Also, WC is specifically associated with insulin resistant T2D.
authors.affiliation: Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America. mmamtani@txbiomedgenetics.org
authors.forename: Manju
authors.initials: M
authors.lastname: Mamtani
authors.forename: Hemant
authors.initials: H
authors.lastname: Kulkarni
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Dyer
authors.forename: Laura
authors.initials: L
authors.lastname: Almasy
authors.forename: Michael C
authors.initials: MC
authors.lastname: Mahaney
authors.forename: Ravindranath
authors.initials: R
authors.lastname: Duggirala
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Comuzzie
authors.forename: John
authors.initials: J
authors.lastname: Blangero
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Curran
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D055105:Waist Circumference; D055815:Young Adult
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