Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Association between indices of obesity and fasting hyperglycemia in Taiwan

International Journal of Obesity volume 28, pages 690–696 (2004)Cite this article

Abstract

OBJECTIVE: To examine the association of body mass index (BMI), waist–hip ratio (WHR), and waist circumference (WC) with fasting hyperglycemia after adjustment for age, cigarette smoking, and alcohol use.

DESIGN: A cross-sectional survey was conducted among individuals visiting four health-screening centers across Taiwan.

SUBJECTS: A total of 61 568 subjects (28 734 men and 32 834 women) between 25 and 64 years of age were included. Fasting hyperglycemia was defined as fasting plasma glucose ≥6.1 mmol/l or current diagnosis and use of insulin or hypoglycemic agent.

RESULTS: Fasting hyperglycemia was found in 11.0% of men and 8.3% of women. The factors significantly associated with fasting hyperglycemia in men were age, BMI, WHR, and heavy drinking, while for women these factors were age, educational level, BMI, WHR, and heavy smoking. For men, increased risk of fasting hyperglycemia started from age 30 to 34 years, BMI ≥25 kg/m2, and WHR ≥0.82. For women, increased risk of fasting hyperglycemia started from age 35 to 39 years, BMI ≥24 kg/m2, and WHR ≥0.74. WC lost its significance as a predictor of fasting hyperglycemia when WHR included in the model.

CONCLUSION: This study found that central obesity and general obesity were both independently associated with increased risk of fasting hyperglycemia in Taiwanese. The relationship between fasting hyperglycemia and central fat accumulation (WHR) begins to appear at levels that would not be regarded as representing obesity in Western populations, suggesting the need to redefine cutoffs for central obesity in this population.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Department of Health. Health and vital statistics: (2) vital statistics. The Executive Yuan, Republic of China: Taiwan Area, ROC, Taipei; 2003.

  2. Available at http://www.doh.gov.tw/statistics/data. Accessed on January 2 2004.

  3. Pan WH, Yeh WT, Chang HY, Hwu CM, Ho LT . Prevalence and awareness of diabetes and mean fasting glucose by age, sex, and region: results from the Nutrition and Health Survey in Taiwan, 1993–1996. Diabet Med 2003; 20: 182–185.

    Article  Google Scholar 

  4. Wang SL, Pan WH, Hwu CM, Ho LT, Lo CH, Lin SL, Jong YS . Incidence of NIDDM and the effect of gender, obesity and hyperinsulinaemia in Taiwan. Diabetologia 1997; 40: 1431–1438.

    Article  CAS  Google Scholar 

  5. King H, Aubert RE, Herman WH . Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabet Care 1998; 21: 1414–1431.

    Article  CAS  Google Scholar 

  6. Harris MI, Eastman RC, Cowie CC, Flegal KM, Eberhardt MS . Comparison of diabetes diagnostic categories in the US population according to 1997 American Diabetes Association and 1980–1985 World Health Organization Diagnostic Criteria. Diabet Care 1997; 20: 1859–1862.

    Article  CAS  Google Scholar 

  7. Tsai ST, Li CL, Chen CH, Chou P . Community-based epidemiological study of glucose tolerance in Kin-Chen, Kinmen: support for a new intermediate classification. J Clin Epidemiol 2000; 53: 505–510.

    Article  CAS  Google Scholar 

  8. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabet Care 1997; 20: 1183–1197.

  9. American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabet Care 1997; 20: 1183–1197.

  10. Okosun IS, Cooper RS, Rotimi CN, Osotimehin B, Forrester T . Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African Americans. Diabet Care 1998; 21: 1836–1842.

    Article  CAS  Google Scholar 

  11. Bermudez OI, Tucker KL . Total and central obesity among elderly Hispanics and the association with type 2 diabetes. Obes Res 2001; 9: 443–451.

    Article  CAS  Google Scholar 

  12. Han TS, Williams K, Sattar N, Hunt KJ, Lean MEJ, Haffner SM . Analysis of obesity and hyperinsulinemia in the development of metabolic syndrome: San Antonio Heart Study. Obes Res 2002; 10: 923–931.

    Article  Google Scholar 

  13. Perry IJ, Wannamethee SG, Walker MK, Thomson AG, Whincup PH, Shaper AG . Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men. BMJ 1995; 310: 560–564.

    Article  CAS  Google Scholar 

  14. Boyko EJ, Fujimoto WY, Leonetti DL, Newell-Morris L . Visceral adiposity and risk of type 2 diabetes: A prospective study among Japanese Americans. Diabet Care 2000; 23: 465–471.

    Article  CAS  Google Scholar 

  15. Huang KC, Lin WY, Lee LT, Chen CY, Lo H, Hsia HH, Liu IL, Shau WY, Lin RS . Four anthropometric indices and cardiovascular risk factors in Taiwan. Int J Obes Relat Metab Disord 2002; 26: 1060–1068.

    Article  Google Scholar 

  16. Lin WY, Lee LT, Chen CY, Lo H, Hsia HH, Liu IL, Lin RS, Shau WY, Huang KC . Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan. Int J Obes Relat Metab Disord 2002; 26: 1232–1238.

    Article  Google Scholar 

  17. Ho SC, Chen YM, Woo JLF, Leung SSF, Lam TH, Janus ED . Association between simple anthropometric indices and cardiovascular risk factors. Int J Obes Relat Metab Disord 2001; 25: 1689–1697.

    Article  CAS  Google Scholar 

  18. Deurenberg-Yap M, Chew SK, Lin VFP, Tan BY, van Staveren WA, Deurenberg P . Relationships between indices of obesity and its comorbidities in multi-ethnic Singapore. Int J Obes Relat Metab Disord 2001; 25: 1554–1562.

    Article  CAS  Google Scholar 

  19. Samaras K, Campbell LV . Increasing incidence of type 2 diabetes in the third millennium: is abdominal fat the central issue? Diabet Care 2000; 23: 441–442.

    Article  CAS  Google Scholar 

  20. World Health Organization. Obesity: prevention and managing the global epidemic, Report of a WHO consultation on obesity, WHO/NUT/NCD/98.1 WHO: Geneva; 1998.

  21. Lukaski HC . Methods for the assessment of body composition: traditional and new. Am J Clin Nutr 1987; 46: 437–456.

    Article  Google Scholar 

  22. Gallagher D, Wisser M, Sepulveda D, Pierson RN, Harris T, Heymsfield SB . How useful is BMI for comparison of body fatness across age, sex and ethnic groups? Am J Epidemiol 1996; 143: 228–239.

    Article  CAS  Google Scholar 

  23. Wei M, Gibbons LW, Mitchell TL, Kampert JB, Blair SN . Alcohol intake and incidence of type 2 diabetes in men. Diabet Care 2001; 23: 18–22.

    Article  Google Scholar 

  24. Manson JE, Ajani UA, Liu S, Nathan DM, Hennekens CH . A prospective study of cigarette smoking and incidence of diabetes mellitus among US male physicians. Am J Med 2000; 109: 538–542.

    Article  CAS  Google Scholar 

  25. Wannamethee S, Goya S, Shaper AG, Perry IJ . Smoking as a modifiable risk factor for type 2 diabetes in middle-aged men. Diabet Care 2001; 24: 1590–1595.

    Article  CAS  Google Scholar 

  26. Facchini FS, Hollenbeck CB, Jeppesen J, Chen YDI, Reaven GM . Insulin resistance and cigarette smoking. Lancet 1992; 339: 1128–1130.

    Article  CAS  Google Scholar 

  27. Facchini F, Chen YDI, Reaven GM . Light-to-moderate alcohol intake is associated with enhanced insulin sensitivity. Diabet Care 1994; 17: 115–119.

    Article  CAS  Google Scholar 

  28. World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. WHO: Geneva; 2000.

  29. Wei M, Gaskill SP, Haffner SM, Stern MP . Waist circumference as the best predictor of noninsulin dependent diabetes mellitus (NIDDM) compared to body mass index, waist/hip ratio over other anthropometric measurement in Mexican Americans: a 7-year prospective study. Obes Res 1997; 5: 16–23.

    Article  CAS  Google Scholar 

  30. Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ . Waist circumference and abdominal sagittal diameter: best simple anthropometric index of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994; 73: 460–468.

    Article  CAS  Google Scholar 

  31. Ko GT, Chan JC, Woo J, Lau E, Yeung VT, Chow CC, Wai HP, Li JK, So WY, Cockram CS . Simple anthropometric indexes and cardiovascular risk factors in Chinese. Int J Obes Relat Metab Disord 1997; 21: 995–1001.

    Article  CAS  Google Scholar 

  32. Robbins JM, Vaccarino V, Zhang H, Kasl SV . Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the Third National Health and Nutrition Examination Survey. Am J Public Health 2001; 91: 76–83.

    Article  CAS  Google Scholar 

  33. Keen H, Jarrett RJ, McCartney P . The ten-year follow-up of the Bedford survey (1962–1972): glucose tolerance and diabetes. Diabetologia 1982; 22: 73–78.

    Article  CAS  Google Scholar 

  34. Wilson PW, Anderson KM, Kannel WB . Epidemiology of diabetes mellitus in the elderly. The Framinghom Study. Am J Med 1986; 80: s3–s9.

    Article  Google Scholar 

  35. Perry RC, Baron AD . Impaired glucose tolerance: why is it not a disease? (Editorial). (Editorial) Diabet Care 1999; 22: 883–885.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was sponsored by MJ Health Screening Center

Author information

Authors and Affiliations

  1. Institute of Community Health Nursing, National Yang-Ming University, Taiwan

    L-Y Chien & Y-M Liou

  2. School of Nursing, National Taiwan University, Taiwan

    Y-M Liou

  3. Yang-Ming Exercise Health Science Institute, Taiwan

    Y-M Liou & J-J Chen

  4. National Yang-Ming University, Taiwan

    J-J Chen

Authors
  1. L-Y Chien
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y-M Liou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J-J Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y-M Liou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chien, LY., Liou, YM. & Chen, JJ. Association between indices of obesity and fasting hyperglycemia in Taiwan. Int J Obes 28, 690–696 (2004). https://doi.org/10.1038/sj.ijo.0802619

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802619

Keywords

This article is cited by

Search

Advanced search

Quick links