title: Thoracic-to-hip circumference ratio as a novel marker of type 2 diabetes, independent of body mass index and waist-to-hip ratio, in Korean adults.
abstract: OBJECTIVE
  We compared upper trunk anthropometric indices with overall and central obesity indicators to predict the presence of type 2 diabetes in middle-aged and elderly Korean individuals.
  
  
  METHODS
  This cross-sectional investigation included 4079 rural and urban participants aged 40-80 years. Neck, thoracic, waist (WC), and hip circumferences were measured by a reliable and standardized method. The neck-to-hip ratio, the thoracic-to-hip ratio (THR), and the waist-to-hip ratio (WHR) were calculated. A 75-g oral glucose tolerance test was performed. Type 2 diabetes was defined based on the guidelines of the World Health Organization (1999).
  
  
  RESULTS
  The receiver operator characteristic curve analysis indicated that THR and WHR were better than body mass index (BMI) and other anthropometric indices at predicting the presence of type 2 diabetes. The adjusted odds ratios (OR) across quartiles of THR were slightly higher than the ORs for WHR, particularly in the highest quartile (odds ratios and 95% CI: 2.11 (1.47-3.04) versus 1.95 (1.37-2.77) in men; 3.40 (2.18-5.31) versus 2.31 (1.48-3.60) in women). The associations of THR and WHR with type 2 diabetes remained significant, despite a slight attenuation after a multivariate adjustment for BMI. The joint effect of BMI and THR on the risk of type 2 diabetes was larger than that of BMI and WHR.
  
  
  CONCLUSIONS
  THR may be a novel marker of type 2 diabetes, particularly in women, and its association with diabetes was independent of BMI and WHR.
authors.affiliation: Korea Institute of Oriental Medicine, 461-24 Jeonmin-dong, Yuseong-gu, Daejeon, Republic of Korea; National Hospital of Traditional Medicine, 29 Nguyen Binh Khiem, Hanoi, Viet Nam.
authors.forename: Duong Duc
authors.initials: DD
authors.lastname: Pham
authors.affiliation: Korea Institute of Oriental Medicine, 461-24 Jeonmin-dong, Yuseong-gu, Daejeon, Republic of Korea.
authors.forename: BonCho
authors.initials: B
authors.lastname: Ku
authors.affiliation: Department of Internal Medicine, Korea University Ansan Hospital, 516, Gojan-1-dong, Danwon-gu, Ansan 425-707, Republic of Korea.
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Nam H
authors.initials: NH
authors.lastname: Cho
authors.affiliation: Korea Institute of Oriental Medicine, 461-24 Jeonmin-dong, Yuseong-gu, Daejeon, Republic of Korea.
authors.forename: Seongwon
authors.initials: S
authors.lastname: Cha
authors.affiliation: Korea Institute of Oriental Medicine, 461-24 Jeonmin-dong, Yuseong-gu, Daejeon, Republic of Korea. Electronic address: ssmed@kiom.re.kr.
authors.forename: Jong Yeol
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose
keywords: Anthropometric index; Type 2 diabetes; Upper-to-lower ratio