Waist circumference is a better predictor than body mass index of insulin resistance in type 2 diabetes
Introduction
Insulin resistance is an important pathogenic factor in type 2 diabetes patents. No easy clinical test exists for predicting the insulin resistance in type 2 diabetes. An easy and efficiency measurement predicting insulin resistance; which can be done easily by type 2 patients is desired.
As we known that poor insulin resistance in type 2 diabetes have high risk to develop cardiovascular disease [1], [2], [3]. Many studies also demonstrated that waist circumference is strong association of cardiovascular disease [4], [5], [6], [7]. Many previous studies have been reported that waist circumference is a stronger predictor of insulin resistance in non-type 2 diabetes [8], [9]. Several studies have indicated that waist circumference is superior to BMI as a risk factor maker in non-type 2 diabetes population [10], [11], [12]. How the association between waist circumference and insulin resistance in type 2 diabetes is worth to investigate.
The different severity or condition of type 2 diabetes might present the different of insulin concentration and resistance. To examine whether waist circumference is a better predictor than body mass index of insulin resistance risk in type 2 diabetes. To avoid the above undectactable coufounders and bias, we examined the type 2 diabetes more than one year, taking gliclazide and metformin more than six months, 30–75 years old, Chinese adult homogenous cohort.
We hypothesized there would be strong association between insulin resistance and waist circumference in homogeneous type 2 diabetes after controlling other factors. This study is to examine the regulation roles of insulin resistance in the homogenous diabetes cohort.
Section snippets
Study population
The trial was conducted from July 2005 through June 2006 in the Taipei Hospital, Taiwan. 1356 registered diabetic subjects were screened. 186 subjects met the inclusion criteria/exclusion criteria (Table 1). A letter explaining the purpose of the study and were sent to the 186 subjects inviting their participation. 144 subjects enrolled and written an informed consent. The protocol was approved by the Human Ethics Committee of Taipei Hospital.
Assessment
Homeostasis model assessment for insulin resistance
Demographics
Among the 1356 screened patients, 186 met the inclusion criteria, 144 (77.4%) agreed to participate. There are 79 female (age 59.0 ± 8.7 years) and 65 male (age 56.3. ± 11.7 years). There are no significant difference in means of age, BMI, waisr circumference, blood pressure, HbA1C, fasting glucose, cholesterol, triglycerol, insulin, HOMA index, aminotransferases alanine, aminotransferases aspartate and creatinine between male and female.
Measurements among HOMA index quartile categories.
Table 2 shows the comparison of characteristics among quartiles
Discussion
Many studies have been demonstrated that insulin resistance is the main pathogenic factor of developing type 2 diabetic disease [1], [2]. The poor control of insulin resistance in type 2 diabetes might be the high risk of complications as cardiovascular disease [4], [5], [6], [7]. It is important to evaluate the insulin resistance in type 2 diabetes. To our knowledge, there is not an available and easy way for patients self-checking and health-worker measurement. The result of this study seemed
Competing interests
None declared.
Acknowledgments
We thank all colleagues in Taipei Hospital, Taiwan for helping with this study. This study was supported by grants from the Taipei Hospital.
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