ارتباط شاخص هاي تن سنجي با شيوع ديابت در جمعيت شهري تهران

Association of different anthropometric measures and type 2 diabetes in an Iranian urban population

Introduction: Obesity is considered to be the most significant risk factor for type 2 diabetes. The aim of this study was to estimate the association of diabetes with body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC). Material and methods: In a cross sectional study from 1999-2001, 7033 participants of the Tehran Lipid and Glucose Study (TLGS) (2992 men and 4041 women) aged 30-69 years, were studied. All subjects underwent clinical examination including anthropometric measurements. Fasting blood glucose after 12-14 hours overnight fasting and blood glucose, 2 hours after ingestion of 75-gr glucose, were measured. Weight, height, waist, and hip circumference were measured according to standard protocols. Diabetes, general and abdominal obesity were defined by using WHO criteria. Results: The overall prevalence of diabetes was 13.4% (11.9 and 14.5% in men and women respectively, p<0.001). The prevalence of diabetes in subjects with general (based on BMI) and abdominal (based on WC and WHR) obesity was 19, 18 and 20.5% respectively, significantly higher than non-obese subjects (11, 6 and 13.4% respectively, p<0.001). In logistic regression analysis the odds ratio (OR) of having diabetes in subjects with general (based on BMI) and abdominal (based on WC and WHR) obesity after adjustment for age and family history of diabetes was 2.17(1.64.2.87), 2.21(1.66-2.94) and 2.36(1.84-3) respectively in men and 1.46(1.2-1.77), 2.37(1.79-2.86) and 2.79(1.96-3.98) respectively in women (p<0.001). After adjustment for other anthropometrical indices, WHR was an independent predictor of diabetes in both sexes (OR of 2 and 1.96 in men and women respectively, p<0.001) while BMI in women and WC in men lost their association with diabetes. When the effect of both total and abdominal obesity in increasing the risk of diabetes were considered, the highest OR was seen in those with both general obesity (high BMI) and abdominal obesity (high WC or WHR). Conclusion: WHR is a suitable predictor of diabetes independent of BMI and WC in both sexes. In comparison to WHR, BMI in women and WC in men are not suitable indices for prediction of diabetes risk.