Comparison of the effects of body mass index and waist circumference on the risk of metabolic syndrome

Abstract

Objective To compare the effects of body mass index and waist circumference on the risk of metabolic syndrome（MS） in obese subjects. Methods Since 2000 a seven-year follow-up study was conducted in 554 subjects（316 men and 238 women）, including 192 subjects with peripheral obesity, 135 with central obesity and 237 with mixed obesity. Before and after the follow-up, adiposity, blood pressure, lipid profile, fasting blood glucose and 2 h blood glucose after glucose loading were measured. Results 520 of 554 subjects were followed up in 2007. Seven-year cumulative incidence of MS was 26.3% （49/186） in subjects with peripheral obesity, 41.7 % （50/120）in those with central obesity and 43.0% （92/214 ）with mixed obesity. The eumulative incidence of MS in subjects with central obesity and mixed obesity were higher than that in subjects with peripheral obesity（X^2 = 7. 825 and X^2 = 12. 082, respectively, both P〈0.01 ） , and the basal levels of diastolic blood pressure,triglyeeride, fasting blood glucose, fasting insulin and insulin resistance index （HOMA-IR） were significantly increased in the former group than the latter（ all P〈0.05 ）. Compared with obese subjects without MS, waist eircumference, waist-hip ratio, fasting blood glueose, fasting insulin and insulin HOMA-IR were significantly increased in subjects with MS （ P〈0.01 or P〈0.05 ） and there was no difference in body mass index between two groups. Logistic analysis showed that waist circumference （P = 0.021 ） , waist-to-hip ratio （P = 0. 009 ） and HOMA-IR（P=0. 004）were major risk faetors of developing MS. Conclusion Central obesity and insulin resistance play a very important role in developing MS, and the effect of waist circumference is a more important risk of MS than body mass index. Key words: Body mass index; Waist eireumferenee; Metabolic syndrome; Follow-up study