Alternative Measurements to Waist Circumference in Diabetic Obese Females

  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. 

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