Abstract
Central obesity is known to be associated with diabetes. Increasing lower extremity circumference was hypothesized in association with lower risk of diabetes. This study determined which anthropometric patterns correlates the best with pre-diabetic and diabetic status among healthy adults. Cross-sectional study with nationwide population sampling of participants was designed. In total, 1,358 ethnic Chinese adult participants were recruited from the Nutrition and Health Survey in Taiwan 2013-2016; the whole-body composition was measured through dual-energy X-ray absorptiometry. Fat and lean mass in whole and specific parts of body among heathy Asian adults with normal glycemic, pre-diabetic, and diabetic states were measured, separately. The generalized linear model was used to investigate the association between body composition (lean and fat mass) and hyperglycemic status. The reduced rank regression (RRR) was used to confirm the correlation between glycemic status and predicting factors (body composition parameters). Trunk fat positively correlated with the fasting glucose level (r = 0.327, P < 0.001) and HbA1c (r = 0.329, P < 0.001), whereas limb fat negatively correlated with the fasting glucose level (r = -0.325, P < 0.001) and HbA1c (ρ = -0.342, P < 0.001), respectively. In RRR analyses, fasting glucose and HbA1c exhibited a high positive association on fat amount per lean mass of the trunk (factor loading = 0.5319 and 0.5599, respectively) and of android area (0.6422 and 0.6104) and a high negative association fat amount per lean mass of the legs (-0.3863 and -0.3083) and gynoid area (-0.3414 and -0.3725). For healthy community participants, increasing trunk fat had a greater risk of hyperglycemic status. Increasing lower extremity mass may confer lower risk of diabetes.
Highlights
Central obesity is markedly associated with numerous hazardous health effects, such as cardiovascular diseases [1, 2], increased insulin resistance [3, 4], and diabetes mellitus [3, 5]
Data are only available from the formal proposal to the Health and Welfare Data Science Center (HWDC), Ministry of Health and Welfare, Taiwan for researchers who meet the criteria for access to confidential data
Trunk fat positively correlated with the fasting glucose level (r = 0.327, P < 0.001) and HbA1c (r = 0.329, P < 0.001), whereas limb fat negatively correlated with the fasting glucose level (r = −0.325, P < 0.001) and HbA1c (ρ = −0.342, P < 0.001), respectively
Summary
Central obesity is markedly associated with numerous hazardous health effects, such as cardiovascular diseases [1, 2], increased insulin resistance [3, 4], and diabetes mellitus [3, 5]. Three waves of the NAHSIT from 1993–1996, 2005–2008, to 2013–2016 have indicated a 2-fold increase in the prevalence of obesity (BMI 27 kg/m2) from 11.8% to 22.0% [6] and diabetes mellitus from 5.3% to 9.1% or above [12] in Taiwan. Numerous single measurement of the adiposity indices, such as BMI, waist circumference, and waist–hip ratio, are simple surrogate markers for central obesity, but they are limited by overlooking the lean and fat mass distribution in adults [13,14,15]. Increasing lower extremity circumference was hypothesized in association with lower risk of diabetes
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