Relationship between Waist Girth, Insulinemia and Metabolic Parameters in Brazilian Adults

Author(s): Pedro Renato Chocair, Precil Diego Miranda de Menezes Neves, Victor Augusto Hamamoto Sato, Sara Mohrbacher, Érico Souza Oliveira, Leonardo Victor Barbosa Pereira, Alessandra Martins Bales, Fagner Pereira da Silva, Fernanda Maluhy Oikawa, John A. Duley, Américo Lourenço Cuvello-Neto

Purpose:

Waist girth, an indirect measure of central fat, is significantly associated with a higher risk of all-cause mortality. The aim of this study was to evaluate the relationship between waist circumference measures with insulinemia, hepatic steatosis and criteria used for diagnosing metabolic syndrome (MS).

Methods:

This is a cross-sectional, retrospective, single-center study in patients who underwent annual check-up appointment at our institution between from October/2020 to March/2021. A total of 1017 adult individuals (74% male), with mean age of 46 years were selected for the study which included Body Mass Index (BMI), waist girth (WG), total fat index (TFI), blood pressure (BP), abdominal ultrasound, fasting insulinemia, in addition to triglyceride, fasting glycemia and High-Density Lipoprotein - Cholesterol (HDL-C) dosages.

Results:

The cut-off for fast hyperinsulinemia diagnosis considered in this analysis was 8 mU/L and 10 mU/L, respectively, for men and women, defined by the mean +2 Standard Deviation (SD) of values found in individuals with two normal (WG + BMI), three normal anthropometric parameters (BMI, TFI and WG), three normal anthropometric parameters (BMI, TFI and WG) and/or without any of the following five criteria for diagnosing metabolic syndrome - BP ≥130/85 mm/Hg or drug treatment for hypertension, HDL-C <40 mg/dL (men), <50 mg/dL (women), glycemia ≥100 mg/dL or hypoglycaemic agents, triglycerides ≥150 mg/dL or drug treatment for hypertriglyceridemia, WG ≥90 cm (men), WG ≥80 cm (women).

Conclusion:

The analysis led to the conclusion that insulinemia, frequency of hepatic steatosis, and all other parameters considered—including BP, HDL-C, triglycerides, and blood glucose—progressively and significantly change with the increase in abdominal circumference. Early reduction of insulinemia in those patients with levels above the cut-off defined in this study, regardless of high adiposity, may provide subsequent clinical benefits.