ORIGINAL ARTICLE   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 October;177(10):578-86

DOI: 10.23736/S0393-3660.17.03721-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The best anthropometric insulin resistance indicators in women

Antonis POLYMERIS ✉, Peter D. PAPAPETROU, Alexis TRAVLOS, Antonia KAPELLA, Paraskevi KONTOU

Second Division of Endocrinology, Alexandra General Hospital, Athens, Greece

BACKGROUND: A correlation between insulin resistance and waist or neck circumference has been previously reported. The purpose of the present study was to investigate which among several body circumferences is the best predictor of the insulin resistance marker Homeostatic Model Assessment (HOMA).
METHODS: In 179 apparently healthy women with a wide range of BMI each of eight body circumferences (neck, waist, hip, arm, forearm, wrist, thigh, and ankle) was correlated with HOMA. The relationship between HOMA and the average of the sum of the eight circumferences (Average Body Circumference, ABC) or the Upper Body Circumference (UBC, average of the sum of neck, waist, arm, forearm, and wrist) or the Lower Body Circumference (LBC, average of the sum of hip, thigh, and ankle) was also evaluated.
RESULTS: The strongest Spearman Rank correlation was found between HOMA and neck circumference (r=0.58, P<0.001)) or UBC (r=0.59, P<0.001) than between HOMA and waist circumference (r=0.54, P<0.001). Three BMI stratified subgroups (normal, overweight, obese) were also analyzed. In the obese women the correlation of HOMA with neck circumference (r=0.57, P<0.001) was frankly stronger than with UBC (r=0.40, P<0.001) or with waist circumference (r=0.28, P=0.03). These results were supported by multiple regression findings. A receiver-operator analysis showed that the neck circumference performed best with sensitivity 77.8% and specificity 73.1% in identifying women with HOMA>2.74 (the 75th percentile of the HOMA values of all participants).
CONCLUSIONS: Neck circumference and an average upper body circumference are the best predictors of the insulin resistance marker HOMA among several other body circumferences.

KEY WORDS: Insulin resistance - Body size - Overweight - Obesity