title: Do differences in waist circumference modify the relationships among body mass index, insulin resistance, and related cardiometabolic risk factors in apparently healthy women?
abstract: OBJECTIVE
  The aims of the study were to (1) compare the cardiometabolic risk profile between insulin-resistant and non-insulin-resistant women within similar body mass indexes (BMIs) and waist circumference (WC) groupings and (2) test the hypothesis that measurements of BMI are not inferior to WC in identifying insulin resistance.
  
  
  METHODS
  The sample consisted of 899 women without known cardiovascular disease or diabetes. BMI was used to divide participants in normal (<25.0 kg/m(2)), overweight (≥25-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)) subgroups, and waist circumference ≥88 cm was used to identify women with or without abdominal obesity. The 25% of the population with highest fasting insulin concentrations was classified as insulin resistant. BMI, WC, blood pressure, and fasting plasma glucose, insulin, triglyceride, and high-density lipoprotein cholesterol concentrations were compared using analysis of covariance (ANCOVA). The relationships between obesity and insulin resistance were analyzed using univariate, multivariate, and logistic regression.
  
  
  RESULTS
  Triglyceride and glucose concentrations were higher and high-density lipoprotein cholesterol concentrations lower in the insulin-resistant group in each BMI category, as was the case when comparing by abdominal obesity. In the univariate analysis, correlations between obesity and the individual cardiometabolic risk factor were significant but weak. In multivariate analysis including both indices, only body mass independently predicted insulin resistance.
  
  
  CONCLUSIONS
  Insulin-resistant women were at greater cardiometabolic risk, irrespective of adiposity category. Obesity contributed to a modest variability in insulin resistance, and abdominal obesity does not add to the ability of BMI to predict insulin resistance.
authors.affiliation: a Hospital Universitario San Martín , La Plata , Buenos Aires , ARGENTINA.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Salazar
authors.forename: Horacio A
authors.initials: HA
authors.lastname: Carbajal
authors.forename: Walter G
authors.initials: WG
authors.lastname: Espeche
authors.forename: Eduardo
authors.initials: E
authors.lastname: Balbín
authors.forename: Marcelo
authors.initials: M
authors.lastname: Aizpurúa
authors.forename: Alberto G
authors.initials: AG
authors.lastname: Marillet
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Reaven
mesh_terms: D050154:Adiposity; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D056128:Obesity, Abdominal / Q000150:complications; D012016:Reference Values; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides