Evaluation of waist-to-height ratio as a predictor of insulin resistance in non-diabetic obese individuals. A cross-sectional study

Author(s)

Jamar, Giovana ^{[1, 2]} ; de Almeida, Flavio Rossi ^{[1, 3]} ; Gagliardi, Antonio ^{[1, 4]} ; Sobral, Marianna Ribeiro ^{[1, 5]} ; Ping, Chao Tsai ^[1] ; Sperandio, Evandro ^[1] ; Romit, Marcelo ^{[1, 4]} ; Arantes, Rodolfo ^{[1, 4]} ; Dourado, Victor Zuniga ^{[1, 6, 7]}

Affiliation

^[1] Univ Fed Sao Paulo UNIFESP, Sao Paulo, SP - Brazil

^[2] Univ Fed Sao Paulo Unifesp, Dept Biosci, Sao Paulo, SP - Brazil

^[3] Univ Fed Sao Paulo Unifesp, Dept Biosci, Dept Human Movement Sci, Sao Paulo, SP - Brazil

^[4] Angiocorpore Inst Med Cardiovasc, Dept Cardiovasc Med, Sao Paulo, SP - Brazil

^[5] Fed Univ Sao Paulo Unifesp, Postgrad Program Food Nutr & Hlth, Sao Paulo, SP - Brazil

^[6] Univ Fed Sao Paulo Unifesp, Lab Epidemiol & Human Movement, Sao Paulo, SP - Brazil

^[7] Univ Fed Sao Paulo Unifesp, Dept Human Movement Sci, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: São Paulo Medical Journal; v. 135, n. 5, p. 462-468, SEP-OCT 2017.
• Web of Science Citations: 1

Abstract

ABSTRACT BACKGROUND: Insulin resistance (IR) and progressive pancreatic β-cell dysfunction have been identified as the two fundamental features in the pathogenesis of obesity and non-insulin-dependent diabetes mellitus. We aimed to investigate correlations between anthropometric indices of obesity and IR in non-diabetic obese individuals, and the cutoff value from receiver operating characteristic (ROC) curve analysis. DESIGN AND SETTING: Cross-sectional study conducted in a private clinic. METHODS: We included obese individuals (body mass index, BMI ≥ 30 kg/m2) with no diabetes mellitus (fasting glucose levels ≤ 126 mg/dl). The participants were evaluated for the presence of cardiovascular risk factors and through anthropometric measurements and biochemical tests. Furthermore, IR was assessed indirectly using the homeostatic model assessment (HOMA)-IR and HOMA-β indexes. The area underthe curve (AUC) of the variables was compared.The sensitivity, specificity and cutoff of each variable for diagnosing IR were calculated. RESULTS: The most promising anthropometric parameters for indicating IR in non-diabetic obese individuals were waist-to-height ratio (WHtR), waist circumference (WC) and BMI. WHtR proved to be an independent predictor of IR, with risk increased by 0.53% in HOMA-IR, 5.3% in HOMA-β and 1.14% in insulin. For HOMA-IR, WHtR had the highest AUC value (0.98), followed by WC (0.93) and BMI (0.81). For HOMA-β, WHtR also had the highest AUC value (0.83), followed by WC (0.75) and BMI (0.73).The optimal WHtR cutoff was 0.65 for HOMA-IR and 0.67 for HOMA-β. CONCLUSION: Among anthropometric obesity indicators, WHtR was most closely associated with occurrences of IR and predicted the onset of diabetes in obese individuals. (AU)

• FAPESP's process: 11/07282-6 - Level of physical activity and fitness and its association with pulmonary function decline in adults in the city of Santos, Brazil
• Grantee: Victor Zuniga Dourado
• Support Opportunities: Research Grants - Young Investigators Grants