Daniel, M., Paquet, C., Kelly, S.J., Zang, G., Rowley, K.G., McDermott, R., and O'Dea, K. (2013) Hypertriglyceridemic waist and newly-diagnosed diabetes among remote-dwelling Indigenous Australians. Annals of Human Biology, 40 (6). pp. 496-504.

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Abstract

Aims: Hypertriglyceridemic waist (HTgW) is predictive of cardiovascular disease. The HTgW relationship with diabetes is little studied.

Methods: This study analysed data from diabetes and cardiovascular risk factor screening programmes in remote Indigenous Australian settlements. Elevated waist girth (EW) was defined as >= 90 cm for men (n = 1134) or >= 80 cm for women (n = 1313). Hypertriglyceridemia (ETg) was defined as >= 1.7 mmol/L. Diabetes was defined as fasting plasma glucose >= 7.0 mmol/L. Body mass index (BMI) was categorised as <22, 22-24.9 and >25.0 kg/m(2). Logistic regression was used to analyse the odds of newly-diagnosed diabetes for individuals with either HTgW, ETg or EW, relative to individuals with values below cut-offs.

Results: The prevalence of HTgW was 33.2% for men and 34.8% for women. Accounting for age-group and gender, newly-diagnosed diabetes was associated (odds ratio (OR) (95% confidence interval)) with HTgW: 9.6 (6.6, 13.8). The relationship remained strong after accounting for the covariates BMI and smoking (OR = 4.9 (2.7, 8.8)). In BMI-stratified analyses the strongest odds were observed for the lowest category (<22 kg/m(2) : OR = 12.9 (4.0, 41.7)).

Conclusions: HTgW has a high prevalence and is associated with newly-diagnosed diabetes in Indigenous people, particularly those with BMI <22 kg/m(2), whom clinicians might not normally consider for screening.

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