NARROW HIPS AND BROAD WAIST CIRCUMFERENCES INDEPENDENTLY CONTRIBUTE TO INCREASED RISK OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Objectives. Patients with non-insulin-dependent diabetes mellitus (NID DM) have been shown to be more obese and have higher waist-to-hips cir cumference ratios compared to nondiabetics. In this study, we tried to dissociate obesity, waist and hip circumference from NIDDM. Design. A cross-sectional population-based case-control study. Setting. General population. Subjects. Controls: 5887 men and 7018 women, aged 20-59 y ears, without known diabetes or hyperglycaemia, Cases: 93 men and 66 w omen were diagnosed with NIDDM. Main outcome measures. We predicted wa ist and hips' circumference from the body mass index, weight/height(2) , (BMI) on the basis of linear regression. Differences between observe d and expected values (residuals) of waist and hip circumference were categorized into tertiles. The relative odds of having NIDDM in tertil es of waist and hip residuals (middle tertile as reference) were calcu lated by multiple logistic regression analysis adjusted for each other and for age, smoking, physical activity, alcohol consumption and educ ation. Results. NIDDM was most prevalent in men and women who had larg er waists and in those who had smaller hip circumferences than expecte d from their BMI. Adjusted odds ratios (95% CI) for NIDDM were 2.9 (1. 6-5.1) in men and 2.8 (1.5-5.1) in women who had a larger than expecte d waist, and were 3.7 (2.1-6.5) in men and 2.1 (1.1-3.8) in women who had smaller than expected hips. Conclusions. Our findings suggest that diabetics have larger waists and smaller hips compared to nondiabetic s, irrespective of their degree of obesity, age and life-style factors . One possibility is that besides abdominal fatness, peripheral muscle atrophy is one of the factors associated with NIDDM.