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Open Access Research article

Waist circumference and insulin resistance: a cross-sectional study of Japanese men

Shinji Tabata1*, Shinichiro Yoshimitsu12, Tadamichi Hamachi12, Hiroshi Abe1, Keizo Ohnaka3 and Suminori Kono2

Author Affiliations

1 Self-Defense Force Fukuoka Hospital, Fukuoka, Japan

2 Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

3 Department of Geriatric Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

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BMC Endocrine Disorders 2009, 9:1  doi:10.1186/1472-6823-9-1

Published: 12 January 2009

Abstract

Background

Visceral obesity is positively related to insulin resistance. The nature of the relationship between waist circumference and insulin resistance has not been known in Japanese populations. This study examined the relationship between waist circumference and insulin resistance and evaluated the optimal cutoff point for waist circumference in relation to insulin resistance in middle-aged Japanese men.

Methods

Study subjects included 4800 Japanese men aged 39 to 60 years. Insulin resistance was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR). The relationship of waist circumference with HOMA-IR was assessed by use of adjusted means of HOMA-IR and odds ratios of elevated HOMA-IR defined as the highest quintile (≥2.00). Receiver operating characteristics (ROC) curve analysis using Youden index and the area under curve (AUC) was employed to determine optimal cutoffs of waist circumference in relation to HOMA-IR.

Results

Adjusted geometric means of HOMA-IR and prevalence odds of elevated HOMA-IR were progressively higher with increasing levels of waist circumference. In the ROC curve analysis, the highest value of Youden index was obtained for a cutoff point of 85 cm in waist circumference across different values of HOMA-IR. Multiple logistic regression analysis also indicated that the AUC was consistently the largest for a waist circumference of 85 cm.

Conclusion

Waist circumference is linearly related to insulin resistance, and 85 cm in waist circumference is an optimal cutoff in predicting insulin resistance in middle-aged Japanese men.