WAIST-TO-HIP RATIO AND PSYCHOSOCIAL FACTORS IN ADULTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS - THE PITTSBURGH EPIDEMIOLOGY OF DIABETES COMPLICATIONS STUDY

The relationship between waist to hip ratio (WHR) and psychosocial fac tors has seldom been investigated, although both may contribute to car diovascular risk. Therefore, these variables were examined in adults w ith insulin-dependent diabetes mellitus ([IDDM] N = 592; mean age, 29 years; mean duration, 20 years), a population at increased risk of dev eloping cardiovascular disease. Moreover, the association between chan ges in psychosocial factors and change in WHR was considered. After ad justing for body mass index (BMI), WHR in men was correlated with high er levels of depressive symptomatology (r = .19, P < .001), greater an xiety (r = .13, P < .05), less social support (r = -.20, P < .01), and lower type A scores (r = -.25, P < .001). In women, WHR was significa ntly correlated with higher levels of depressive symptomatology (r = . 18, P < .01), greater stress (r = .16, P < .01), and alcohol consumpti on (r = .12, P < .05). For both sexes, smokers had a significantly gre ater mean WHR than nonsmokers (P < .01). For men, multiple regression analyses adjusting for BMI and age demonstrated that smoking, lower in come, less exercise, and lower type A scores were the most significant variables associated with WHR. In women, the independent predictors o f WHR were a history of smoking, lower educational level, and depressi ve symptomatology. The most significant independent predictors of chan ge in WHR from baseline to 2-year follow-up study were change in weigh t (men), change in BMI (women), and change in depression scores (both sexes). These results suggest that psychosocial factors may affect car diovascular disease risk through their influence on body fat distribut ion, and both may be important in identifying those most at risk for c ardiovascular disease in populations with IDDM. (C) 1996 by W.B. Saund ers Company