Freedman D S, Rimm A A
Division of Biostatistics and Clinical Epidemiology, Medical College of Wisconsin, Milwaukee.
Am J Public Health. 1989 Jun;79(6):715-20. doi: 10.2105/ajph.79.6.715.
Independently of the amount of adipose tissue, certain patterns of fat distribution increase the risk of non-insulin-dependent diabetes. Although the ratio of waist to hip (WHR) circumferences has been consistently related to diabetes mellitus, it is possible that only two measures do not completely characterize fat topography. The current study, therefore, examines the cross-sectional relation of six girths (waist, hip, neck, bust, wrist, and ankle) to diabetes mellitus in 43,595 women. As compared with non-diabetics, Quetelet index (kg/m2) and all circumferences were elevated among diabetics. Stratified analyses showed that WHR, and waist, neck, and bust girths were consistently related to diabetes independently of the degree of overweight. As estimated from a logistic regression model that simultaneously controlled for age and all anthropometric variables, the prevalence of diabetes mellitus was positively related to Quetelet index, and to the waist, bust, and neck girths, with odds ratios (ORs) ranging from 1.4 to 2.6. However, diabetes was inversely related to hip (OR = 0.61) and ankle (OR = 0.73) girths; p less than 0.005 for each association. Although cross-sectional in nature, these results suggest that an adverse body fat distribution is not limited to the abdominal region, but that a relative preponderance of adipose tissue in various regions of the upper body is associated with diabetes mellitus in women.
无论脂肪组织的量如何，某些脂肪分布模式都会增加非胰岛素依赖型糖尿病的风险。尽管腰臀比（WHR）一直与糖尿病相关，但仅用这两个指标可能无法完全描述脂肪分布情况。因此，本研究调查了43595名女性中6个围度（腰围、臀围、颈围、胸围、腕围和踝围）与糖尿病之间的横断面关系。与非糖尿病患者相比，糖尿病患者的克托莱指数（kg/m2）和所有围度均升高。分层分析表明，独立于超重程度，腰臀比以及腰围、颈围和胸围均与糖尿病持续相关。根据同时控制年龄和所有人体测量变量的逻辑回归模型估计，糖尿病患病率与克托莱指数以及腰围、胸围和颈围呈正相关，比值比（OR）范围为1.4至2.6。然而，糖尿病与臀围（OR = 0.61）和踝围（OR = 0.73）呈负相关；各关联的p值均小于0.005。尽管本研究本质上是横断面研究，但这些结果表明，不良的体脂分布不仅限于腹部区域，而且上身各部位脂肪组织的相对优势与女性糖尿病相关。
