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Use of waist circumference to predict insulin resistance: retrospective study

Insulin resistance is an important pathogenic factor in common metabolic disorders. No easy clinical test exists for predicting the insulin resistance of an individual. We assessed how effectively different anthropometric measurements and biochemical markers used in clinical practice can predict insulin sensitivity.

We analysed a sample of 2746 healthy volunteers (798 male) from retrospectively collected data. Ages ranged from 18 years to 72 years, body mass index (kg/m2) from 18 to 60, and waist circumferences from 65 cm to 150 cm (see table A on bmj.com for further data). We determined height, weight, waist circumference (mid-way between the lateral lower ribs and the iliac crest), and hip circumference. Results from analyses of venous plasma for glucose, insulin, lipids, and leptin concentrations were used. We used homoeostasis model assessment (HOMA index) as a measure of insulin sensitivity (plasma glucose (mol/l) x plasma insulin (mU/l)/22.5)—an established test in epidemiological studies.1 We defined insulin resistance as a HOMA score > 3.99, on the basis of a definition for a white population.2

We used multivariate regression models to …