5 :: KDA, Korean Diabetes Association ::
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Subject    :    [2015 Jun;39(3)] Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes
Writer KDA
Date 2015-07-07 18:36:04 Hit 5,357
LINK URL http://www.e-dmj.org/DOIx.php?id=10.4093/dmj.2015.39.3.253 (Click 526)
Diabetes Metab J. 2015 Jun;39(3):253-263. English. Published online Apr 24, 2015.  http://dx.doi.org/10.4093/dmj.2015.39.3.253 
Copyright © 2015 Korean Diabetes Association
   
Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes
Jung Soo Lim,1 Young Ju Choi,2 Soo-Kyung Kim,3 Byoung Wook Huh,2 Eun Jig Lee,4 and Kap Bum Huh2
1Division of Endocrinology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
2Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, Seoul, Korea.
3Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
4Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Corresponding author: Kap Bum Huh. Huh's Diabetes Center and the 21C Diabetes and Vascular Research Institute, 120 Sinchon-ro, Mapo-gu, Seoul 121-806, Korea. Email: huh7181827@hanmail.net Corresponding author: Eun Jig Lee. Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Email: ejlee423@yuhs.ac 
 
Received June 02, 2014; Accepted September 15, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract
Background

Visceral obesity is the most powerful contributor to the development of metabolic syndrome (MetS) and cardiovascular diseases. In light of visceral obesity, however, there is a paucity of data on the appropriate cutoff point of waist circumference (WC) in subjects with type 2 diabetes. The aim of this study was to investigate the optimal cutoff value for WC that signals insulin resistance (IR) and visceral obesity in Koreans with type 2 diabetes.

Methods

We evaluated 4,252 patients with type 2 diabetes (male 2,220, female 2,032, mean age 57.24 years) who visited our clinic between January 2003 and June 2009. WC was measured at the midpoint between the lower rib and the iliac crest, and insulin sensitivity was assessed by the rate constant of plasma glucose disappearance (Kitt %/min) using an insulin tolerance test. Visceral fat thickness was measured using ultrasonography. Statistical analysis was performed using receiver operating characteristic curve.

Results

The optimal cutoff points for WC for identifying the presence of IR and visceral obesity, as well as two or more metabolic components, were 87 cm for men and 81 cm for women. Moreover, these cutoff points had the highest predictive powers for the presence of visceral obesity. The MetS defined by new criteria correlated with the increased carotid intima-media thickness in female subjects.

Conclusion

Our results suggest that the optimal cutoff values for WC in Koreans with type 2 diabetes should be reestablished based on IR and visceral obesity.

   

 

Keywords: Diabetes mellitus, type 2, Insulin resistance, Obesity, abdominal, Waist circumference.

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