Alternative Measurements to Waist Circumference in Diabetic Obese Females

Year 2019, , 22 - 27, 11.03.2019

Sabah Tuzun , Can Öner , Mehmet Akman , Burak Ölmez Reşat Dabak , Ekrem Orbay

https://doi.org/10.21763/tjfmpc.527970

Abstract

 

Introduction:
Although waist circumference measurement is frequently used for the assessment
of abdominal fat mass, this method has some limitations. Among alternative
anthropometric measurements, neck circumference is effective in reflecting the
upper body fat distribution, whereas arm circumference is effective in
reflecting insulin resistance. The present study aimed to evaluate the
relationship between waist circumference and neck and arm circumferences in
obese female patients with type 2 diabetes mellitus (DM).

Method:
Diabetic female patients, who visited the Diabetes Outpatient Clinic between
April and June 2015 and had a body mass index (BMI) of ≥ 30 kg/m²,
were enrolled in the study. Anthropometric measurements included body weight,
height, BMI, waist circumference, neck circumference and both arm circumference
in all participants.

Results:
A total of 285 participants were included in the study; arm circumference was
measured in 284 (99.65%) and neck circumference was measured in 227 (79.65%).
Overall mean BMI was 37.4±5.6 kg/m², mean waist circumference was
117.8±12.1 cm, mean neck circumference was 39.6±3.5 cm, and mean arm
circumference was 35.7±4.9 cm. After adjusting for age and duration of DM,
waist circumference showed strong positive correlation with BMI but moderately
positive significant correlation with neck circumference and arm circumference
(p<0.001, p<0.001 and p<0.001, respectively). Stepwise regression
analysis, which was performed with the independent variables BMI, neck circumference
and arm circumference for the dependent variable waist circumference, indicated
that BMI (R²=0.544 and p<0.001), BMI and neck circumference (R²=0.599
and p<0.001) are significant. However, there was no significant relationship
between waist circumference and arm circumference (p>0.05).

Conclusion:
Waist circumference showed strong positive correlation with BMI but moderately
positive correlation with neck and arm circumferences. Among anthropometric
measurements, BMI has the highest efficacy in estimating waist circumference,
whereas neck circumference has lower efficacy. Moreover, arm circumference has
no significant effect in estimating waist circumference.

 

Giriş:
Abdominal yağ kitlesinin değerlendirilmesi amacıyla sıklıkla bel çevresi ölçümü
kullanılmakla beraber, bel çevresi ölçümü ile ilgili kısıtlılıklar mevcuttur.
Alternatif antropometrik ölçümlerden boyun çevresinin üst vücut yağ dağılımını
gösterdiği ve kol çevresinin insulin direncini göstermede etkili olduğu
saptanmıştır. Bu çalışma tip 2 diyabet hastası olan obez ve morbid obez
kadınlarda bel çevresi ile boyun ve kol çevresi arasındaki ilişkinin
değerlendirilmesini amaçlamaktadır.

Yöntem:
Çalışmaya Diyabet Merkezi’ne Nisan – Haziran 2015 tarihleri arasında başvuran
ve beden kitle indeksi (BKİ) ≥ 30 kg/m² olan kadın DM hastaları
dahil edilmiştir. Tüm katılımcıların
antropometrik ölçüm değerlendirmelerinde vücut ağırlığı, boy, BKİ, bel çevresi, boyun çevresi ve her iki kol
çevresi ölçümleri değerlendirilmiştir.

Bulgular:
Çalışmaya toplam 285 katılımcı kabul edilmiş olup 284 (%99.65) katılımcının kol
çevresi ve 227 (%79.65) katılımcının boyun çevresi ölçümleri
değerlendirilmiştir. Katılımcıların BKİ ortalaması 37.4±5.6 kg/m²,
bel çevresi ortalaması 117.8±12.1 cm, boyun çevresi ortalaması 39.6±3.5 cm ve
kol çevresi ortalaması 35.7±4.9 cm olarak tespit edilmiştir. Yaş ve DM süresi
control altına alındığında bel çevresi ile BKİ arasında güçlü pozitif, boyun ve
kol çevresi arasında orta düzeyde pozitif anlamlı ilişki saptanmıştır
(sırasıyla p<0.001, p<0.001 ve p<0.001). Katılımcıların bel çevresi
bağımlı değişkeni için BKİ, boyun ve kol çevresi bağımsız değişkenleri ile
yapılan aşamalı regresyon analizinde BKİ (R²=0.544 ve p<0.001),
BKİ ve boyun çevresi (R²=0.599 ve p<0.001) anlamlı tespit
edilmiştir. Bununla beraber, bel çevresi ve kol çevresi arasında ilişki
saptanmamıştır (p>0.05).

Tartışma:
Bu çalışmada bel çevresi ile BKİ arasında güçlü pozitif ilişki saptanırken,
boyun ve kol çevresi arasında orta düzeyde pozitif bir ilişki saptanmıştır. Bel
çevresinin antropometrik ölçümlerle tahmin edilmesinde ise BKİ en yüksek
etkinliğe sahipken, boyun çevresi daha düşük etkinlikte tespit edilmiştir.
Ayrıca kol çevresinin ise bel çevresinin tahmin edilmesinde anlamlı etkisi
saptanmamıştır. 

Keywords

Type 2 Diabetes Mellitus, Anthropometry, Waist Circumference, Body Mass Index

References

• 1. Wang X, Zhang N, Yu C, Ji Z. Evaluation of neck circumference as a predictor of central obesity and insulin resistance in Chinese adults. Int J ClinExp Med 2015;8(10):19107-13.
• 2. Gelber RP, Gaziano JM, Orav EJ, Manson JE, Buring JE, Kurth T. Measures of obesity and cardiovascular risk among men and women. J Am Coll Cardiol2008;52:605–15. 3. Stabe C, Vasques ACJ, Lima MMO, Tambascia MA, Pareja JC, Yamanaka A, et al. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: Results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf) 2013;78(6):874–81.
• 4. Qureshi NK, Hossain T, Hassan MI, Akter N, Rahman MM, Sultana MM, et al. Neck Circumference as a Marker of Overweight and Obesity and Cutoff Values for Bangladeshi Adults. Indian J Endocrinol Metab 2017;21(6):803-808.
• 5. Mason C, Craig CL, Katzmarzyk PT. Influence of central and extremity circumferences on all-cause mortality in men and women. Obesity (Silver Spring) 2008;16(12):2690-5.
• 6. Cho NH, Oh TJ, Kim KM, Choi SH, Lee JH, Park KS, et al. Neck circumference and incidence of diabetes mellitus over 10 Years in the Korean Genome and Epidemiology Study (KoGES). Sci Rep 2015;5:18565.
• 7. Aswathappa J, Garg S, Kutty K, Shankar V. Neck circumference as an anthropometric measure of obesity in diabetics. N Am J Med Sci 2013;5(1):28–31.
• 8. Tang AM, Dong K, Deitchler M, Chung M, Maalouf-Manasseh Z, Tumilowicz A, et al. Use of cutoffs for mid-upper arm circumference (MUAC) as an indicator or predictor of nutritional and health-related outcomes in adolescents and adults: A systematic review. 2013. Food and Nutrition Technical Assistence III Project (FANTA). https://www.fantaproject.org/sites/default/files/resources/MUAC%20Systematic%20Review%20_Nov%2019.pdf (accessed 30 March 2018).
• 9. Chao YP, Lai YF, Kao TW, Peng TC, Lin YY, Shih MT, et al. Mid-arm muscle circumference as a surrogate in predicting insulin resistance in non-obese elderly individuals. Oncotarget 2017;8(45):79775-79784.
• 10. World Health Organization. BMI classification. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html (accessed 12 January 2018).
• 11. Sebo P, Haller D, Pechère-Bertschi A, Bovier P, Herrmann F. Accuracy of doctors' anthropometric measurements in general practice. Swiss Med Wkly 2015;145:w14115.
• 12. Chang Y, Guo X, Chen Y, Guo L, Li Z, Yu S, et al. A body shape index and body roundness index: two new body indices to identify diabetes mellitus among rural populations in northeast China. BMC Public Health 2015;15:794.
• 13. Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, et al; Beijing Community Diabetes Study Group. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care 2010;33(11):2465-7.
• 14. Khalangot M, Gurianov V, Okhrimenko N, Luzanchuk I, Kravchenko V. Neck circumference as a risk factor of screen-detected diabetes mellitus: community-based study. DiabetolMetabSyndr2016;8:12.
• 15. Freedman DS, Rimm AA. The relation of body fat distribution, as assessed by six girth measurements, to diabetes mellitus in women. Am J Public Health 1989;79(6):715–20.
• 16. Noudeh YJ, Hadaegh F, Vatankhah N, Momenan AA, Saadat N, Khalili D, et al. Wrist circumference as a novel predictor of diabetes and prediabetes: Results of cross-sectional and 8,8-year follow-up studies. J Clin Endocrinol Metab 2013; 98(2): 777-84.
• 17. Tanvir A, Nadim H. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging 2010;5:207-16.