Abdominal Obesity and Physical Inactivity as Risk Factors for NIDDM and Impaired Glucose Tolerance in Indian, Creole, and Chinese Mauritians

Dowse, Gary K.; Zimmet, Paul; Gareeboo, H.; George, K.; Alberti, M.M.; Tuomilehto, Jaakko; Finch, Caroline F.; Chitson, Pierrot; Tulsidas, Haresh

doi:10.2337/diacare.14.4.271

Cited by 207 publications

(132 citation statements)

References 23 publications

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“…59 A similar relationship between diabetes and obesity has been described previously in American Indians. 60 The ®nd-ings of the present study, based on cross-sectional data, support the view that diabetes and obesity are intimately linked in this ethnic subgroup.…”

Section: Discussionmentioning

confidence: 59%

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study

et al. 2000

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and 4 Aberdeen Tribal Chairmen's Health Board, Rapid City, SD, USA OBJECTIVE: To examine the hypothesis linking measures of obesity including body mass index (BMI), waist circumference (waist) and percentage body fat to coronary heart disease (CHD) prevalence and its risk factors in American Indians. DESIGN: The Strong Heart Study assesses the prevalence of CHD and its risk factors in American Indians in Arizona, Oklahoma and SouthaNorth Dakota. Participants underwent a physical examination and an electrocardiogram; anthropometric and blood pressure measurements were taken, as were measurements of glucose, lipoproteins, ®brinogen, insulin, hemoglobin A 1c and urinary albumin. PARTICIPANTS: Data were available for 4549 men and women between 45 and 74 y of age. MEASUREMENTS: Obesity, measured using body mass index, waist circumference and percentage body fat, was correlated with prevalent CHD and its risk factors. RESULTS: More than 75% of participants were overweight (BMI b 25 kgam 2 ). Measures of obesity were greater in women than in men, in younger than in older participants, and in participants with diabetes than in nondiabetic participants. CHD risk factors were associated with measures of obesity but, except for insulin concentration, changes in metabolic variables with increasing obesity were small. Associations were not stronger with waist than with BMI. The prevalence of CHD in those whose BMI andaor waist measurements lay in the lowest and highest quintiles, by gender and diabetic status, was similar. CONCLUSIONS: Although CHD risk factors are associated with obesity in American Indians, distribution of obesity (ie waist) is no more closely related to risk factors than is generalized obesity (ie BMI), and changes in CHD risk factors with obesity were small. Thus, the relations among obesity, body fat distribution and CHD risk may differ in this population.

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Section: Discussionmentioning

confidence: 59%

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study

et al. 2000

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“…Hip circumference (HC) was measured at the maximum circumference at the level of femoral trochanter. 12 Waist-hip ratio was calculated by WC divided by HC. All subjects had blood taken after a 12-h fasting period for measurement of high-density lipoprotein cholesterol (HDL-C), triglycerides, low-density lipoprotein cholesterol (LDL-C), liver enzymes and plasma glucose.…”

Section: Methodsmentioning

confidence: 99%

Mesenteric fat thickness as an independent determinant of fatty liver

Liu

Chan

et al. 2006

Int J Obes

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Objective: Mesenteric fat is drained by the portal circulation and has been suggested to be a key component in obesity-related health risk, notably the metabolic syndrome. There are increasing epidemiological and experimental data showing that fatty liver is another component of this multifaceted syndrome. Given their intimate anatomical and physiological relationships, we hypothesized that mesenteric fat thickness may be independently associated with the risk of fatty liver. To test this hypothesis, we examined the predictive role of various fat deposits including mesenteric fat thickness, and various metabolic variables on the risk of fatty liver. Subjects and methods: A total of 291 Chinese subjects (134 men and 157 women with a mean BMI of 23.7 kg/m 2 , range: 16.5-33.4 kg/m 2 ) underwent ultrasound examination for measurement of mesenteric, subcutaneous and preperitoneal fat thickness, and for diagnosis of fatty liver. Body mass index, waist circumference, and waist-hip ratio were recorded. Blood pressure was measured. Fasting plasma glucose, insulin resistance, high-density lipoprotein cholesterol (HDL-C), triglycerides, low-density lipoprotein cholesterol (LDL-C), liver enzymes were determined by common methods. Results: The subjects with fatty liver had greater abdominal fat thickness and higher anthropometric indexes than those without fatty liver. The subjects with fatty liver also showed higher blood pressure, worse lipid and glycaemic profile compared with those without fatty liver. Using multiple logistic regression analysis, mesenteric fat thickness was a risk factor of fatty liver, independent of body mass index, age, sex, insulin resistance, fasting plasma glucose, lipid and blood pressure. The odds ratio was 1.5 (95% confidence interval: 1.27-1.77) for every 1 mm increase in the mesenteric fat thickness. Measurement of preperitoneal and subcutaneous fat deposits did not show significant associations with fatty liver. Conclusion: Mesenteric fat thickness measured on ultrasound is an independent determinant of fatty liver.

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“…The subjects were drawn from a populationbased non-communicable disease survey performed in Mauritius in 1987 and are described in detail elsewhere. 17,18 Mauritius is an island nation located in the southwestern Indian Ocean. The multiethnic population comprises about 70% of Asian Indian origin, 27.9% Creole (mixed with mainly African ancestry) and 2.1% Chinese.…”

Section: Methodsmentioning

confidence: 99%

“…19 Body mass index (BMI) was calculated as kgam 2 and waist and hip girth were measured in duplicate to calculate waist to hip ratio (WHR) from the means of measurements as previously described. 18 Eligibility for the present study was limited to 1227 men and 1310 women who had normal glucose tolerance 19 in 1987, and who also attended a followup survey in 1992. Serum leptin levels were only available for those who participated in both surveys.…”

Section: Methodsmentioning

confidence: 99%

Is there a relationship between leptin and insulin sensitivity independent of obesity?A population-based study in the Indian Ocean nation of Mauritius

Collins²,

et al. 1998

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and 7 WHO Of®ce, Port Louis, Mauritius OBJECTIVE: It has been shown previously in smaller studies that fasting serum leptin and insulin concentrations are highly correlated, and insulin sensitive men have lower leptin levels than insulin resistant men matched for fat mass. We have examined the association between insulin resistance (assessed by fasting insulin) and leptin after controlling for overall and central adiposity in a population-based cohort. DESIGN: Leptin levels were compared across insulin resistance quartiles within three categories of obesity (tertiles of body mass index (BMI)). Partial correlation coef®cents and multiple linear regression models were used to assess the relationship between leptin and fasting insulin after adjusting for BMI and waist to hip ratio (WHR) or waist circumference. SUBJECTS: Subjects were normoglycemic participants of a 1987 non-communicable diseases survey conducted in the multiethnic population of Mauritius. 1227 men and 1310 women of Asian Indian, Creole and Chinese ethnicity had normal glucose tolerance and fasting serum leptin measurements. RESULTS: Mean serum leptin concentration increased across quartiles of fasting insulin in each BMI group and gender, after controlling for BMI, WHR and age. Furthermore, fasting insulin was a signi®cant determinant of serum leptin concentration, independent of BMI and WHR, in both men and women. Similar results were found if waist circumference replaced BMI and WHR in the model. CONCLUSION: These results suggest that insulin resistanceaconcentration may contribute to the relatively wide variation in leptin levels seen at similar levels of body mass or alternatively, leptin may play a role in the etiology of insulin resistance. Further studies will be important to determine whether the hyperleptinemiaainsulin resistance relationship has a role in the natural history of obesity, Type 2 diabetes mellitus and the other metabolic abnormalities associated with insulin resistance.

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Abdominal Obesity and Physical Inactivity as Risk Factors for NIDDM and Impaired Glucose Tolerance in Indian, Creole, and Chinese Mauritians

Cited by 207 publications

References 23 publications

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study

Mesenteric fat thickness as an independent determinant of fatty liver

Is there a relationship between leptin and insulin sensitivity independent of obesity?A population-based study in the Indian Ocean nation of Mauritius

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