Central Rather than Generalized Obesity is Related to Hyperglycaemia in Asian Indian Subjects


Wellcome Diabetes Study, King Edward Memorial Hospital, Pune, India 411011


The relationship of body mass index and waist-hip ratio with plasma glucose concentrations during an oral glucose tolerance test (OGTT) was studied in native Indian (Asian) subjects. A total of 389 subjects (131 non-diabetic, 74 impaired glucose tolerant (IGT) and 184 Type 2 diabetic (newly diagnosed and untreated)) were studied. Prevalence of obesity (BMI geqslant R: gt-or-equal, slanted 27.0 kg m−2 in men and geqslant R: gt-or-equal, slanted 25.0 kg m−2 in women, 21% and 47%, respectively) was lower in people with Type 2 diabetes than that reported in white Caucasian and migrant Asian populations. Body mass index was highest in IGT subjects (26.1 (19.7−34.3) kg m−2, median (5-95th centile)) and was higher in diabetic subjects (24.2 (19.3−32.2) kg m−2) than in non-diabetic control subjects (23.5 (17.1−30.0) kg m−2). However, waist-hip ratio was higher in both IGT (0.88 (0.75−0.98)) and diabetic subjects (0.88 (0.75−1.00)) than in non-diabetic control subjects (0.83 (0.70−0.97)), with no difference between the hyperglycaemic groups. On multivariate analysis, fasting as well as 2-h plasma glucose concentrations during OGTT were found to be related to waist-hip ratio (p<0.01) and subscapular fat thickness (p<0.01) but not to body mass index (or triceps fat thickness). Thus, in native Indians central obesity seems to be a more important association of hyperglycaemia than generalized obesity.