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- Title
The National Cholesterol Education Program-Adult Treatment Panel Ill Guidelines Overestimates the Association between Insulin Resistance and Central Obesity in African American Women.
- Authors
Sen, Sabyasachi; Chow, Carson C.; Ricks, Madia; G. Sebring, Nancy; Frempong, Barbara A.; Sumner, Anne E.
- Abstract
Central obesity is defined by waist circumference (WC) thresholds set by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) (Men ≥ 102 cm, Women ≥ 88 cm). The validity of these thresholds in African Americans is unknown. As insulin resistance is etiologically linked to central obesity, our goal was to determine the WC in African Americans which predicts insulin resistance. Subjects were 131 African Americans (68M, 63W), age 35±8, (mean±SD), BMI30.9±7.5, range 18.5-54.7 kg/m², WC 98±18, range 69-173 cm. S[sub 1] was determined in each subject from minimal model analyses. Insulin resistance was defined as S[sub 1]<2.0 min[sup -1].uU[sup -1].mL. The ability of WC to predict insulin resistance was determined using receiver operating characteristic (ROC) curves. To determine the WC cut-off which best predicts insulin resistance the following were calculated for 1 cm increments of WC from 80 to 110 cm: sensitivity, specificity, odds ratio and diagnostic accuracy. Diagnostic accuracy is the percent of correct decisions. For the entire population mean St was 3.67±2.39, range 0.17-12.75 and the area under the ROC curve for WC as a predictor of insulin resistance was 0.79±0.06, 95% CI 0.72-0.88. For men a single WC (≥ 102 cm) had the highest diagnostic accuracy (78%) with a sensitivity of 73%, specificity of 80% and odds ratio of 10.4, P<0.001. For women a single WC (≥99 cm) had the highest diagnostic accuracy (80%) with a sensitivity of 86%, specificity of 77% and odds ratio of 19.2, P<0.001. In conclusion. we demonstrate that WC predicts insulin resistance. The NCEP-ATP III guidelines for central obesity (WC≥102 cm) optimally predicts insulin resistance in African American men. But, for African American women the WC that best predicts insulin resistance is ≥99 cm. NCEP-ATPIII guidelines for the diagnosis of central obesity in women (WC≥88 cm) overestimates risk of insulin resistance in African American women.
- Publication
Diabetes, 2007, Vol 56, pA264
- ISSN
0012-1797
- Publication type
Academic Journal