title: Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: Comparisons of representative nationwide sample data.
abstract: Variation among ethnic groups in the association between obesity and insulin resistance (IR)/diabetes has been suggested, but studies reported inconsistent results. We evaluated ethnic differences in the association between obesity and insulin resistance (IR)/diabetes.
  
  
  
  We conducted a cross-sectional analysis using Korea (n=18,845) and the USA (n=4657) National Health and Nutrition Examination Survey(NHANES) 2007-2010. We performed statistical comparisons of AUC-ROC (area under the curve in a receiver operating characteristic curve) values for body mass index (BMI), waist circumference (WC) and homeostasis model assessment of insulin resistance (HOMA-IR) to predict IR or diabetes among different ethnic groups.
  
  
  
  AUC-ROC values for BMI and WC for predicting IR were highest in Whites (0.8324 and 0.8468) and lowest in Koreans (0.7422 and 0.7367). Whites showed the highest AUC-ROC values for BMI (0.6869) and WC (0.7421) for predicting diabetes, while the AUC-ROC for HOMA-IR was highest in Koreans (0.8861). Linear regression showed significant interactions between ethnicity and the main effects (all P<0.0001). Increases in BMI were associated with a larger increase in HOMA-IR in Whites (β=0.0719) and WC in Hispanics (β=0.0324), while BMI was associated with a larger increase in fasting glucose in Koreans (β=0.8279) and WC in Blacks (β=0.4037). In addition, the slope for fasting glucose with increasing HOMA-IR was steeper in Koreans (β=16.5952, P<0.001) than in other groups.
  
  
  
  The ability of BMI and WC to predict IR and diabetes was highest in Whites, while the ability of HOMA-IR to predict diabetes was highest in Koreans.
authors.affiliation: Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do, South Korea.
authors.forename: Yeong Sook
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea.
authors.forename: Han Seok
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Seoul Na Eun Hospital, Seoul, South Korea; Department of Family Medicine, Center for Obesity, Metabolism and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea.
authors.forename: Jin Kuk
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Center for Obesity, Metabolism and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea.
authors.forename: Yu Il
authors.initials: YI
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Center for Obesity, Metabolism and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea; Channelopathy Research Center, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea. Electronic address: osw6021@yahoo.co.kr.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Oh
mesh_terms: D000328:Adult; D019540:Area Under Curve; D044466:Asian People; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology; D012372:ROC Curve; D056910:Republic of Korea; D014481:United States; D055105:Waist Circumference; D044465:White People; D001741:Black or African American
chemical_list: D001786:Blood Glucose
keywords: Body mass index; Ethnic differences; Insulin resistance; Type 2 diabetes; Waist circumference