Consequences of Change in Waist Circumference on Cardiometabolic Risk Factors Over 9 Years

doi:10.2337/dc06-2542

Consequences of Change in Waist Circumference on Cardiometabolic Risk Factors Over 9 Years

Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR)

Beverley Balkau, PHD12,
Pascaline Picard, MSC12,
Sylviane Vol, MSC3,
Leopold Fezeu, MD, MSC12,
Eveline Eschwège, MD12 and
for the DESIR Study Group *

¹Institut National de la Santé et de la Recherche Médicale, Unité 780-IFR69, Epidemiological and Biostatistical Research, Villejuif, France
²Université Paris Sud, Kremlin Bicêtre, France
³Institut Inter-Régional pour la Santé, La Riche, France

Address correspondence and reprint requests to Beverley Balkau, INSERM U780-IFR69, 16 Ave. Paul Vaillant-Couturier, 94807, Villejuif, France. E-mail: balkau{at}vjf.inserm.fr

DESIR, Data from an Epidemiological Study on the Insulin Resistance Syndrome

Obesity and abdominal adiposity have been shown in prospective studies to be risk factors for cardiovascular disease and particularly for diabetes (1–8). In cross-sectional studies, both are related with risk factors for these diseases (9–12), but there are few publications on the effects of changes in abdominal adiposity (13). We characterized men and women who gained and lost abdominal adiposity over 9 years and describe the incidence and the improvement in cardiometabolic risk factors according to changes in waist circumference.

RESEARCH DESIGN AND METHODS—

From the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort (9,14,15), 1,868 men and 1,939 women aged 30–64 years at baseline were followed over 9 years. The 73% of the baseline cohort that we studied were older, less frequently abdominally obese, hypertriglyceridemic, hyperinsulinemic, smokers, and fewer had metabolic syndrome. Cardiometabolic abnormalities and the metabolic syndrome were defined according to the National Cholesterol Education Program (NCEP) criteria (16), except high blood pressure, which included antihypertensive treatment (Table 1); hyperinsulinemia was defined by upper quartiles of fasting insulin ≥57.3 pmol/l for men and ≥52.8 pmol/l. The incidence and improvement of cardiometabolic risk factors were studied by age-adjusted logistic regression, according to waist change: ≤ −3.0 cm, −2.9 to +2.9 cm, 3.0–6.9 cm, and ≥7.0 cm. Statistical significance was defined as P < 0.05.