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Use of waist circumference to predict insulin resistance: retrospective study

BMJ 2005; 330 doi: (Published 09 June 2005) Cite this as: BMJ 2005;330:1363
  1. Hans Wahrenberg (, senior consultant1,
  2. Katarina Hertel, research nurse1,
  3. Britt-Marie Leijonhufvud, research nurse1,
  4. Lars-Göran Persson, biomedical engineer2,
  5. Eva Toft, senior consultant1,
  6. Peter Arner, professor1
  1. 1 Department of Medicine M61, Karolinska Institutet at Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden,
  2. 2 Department of Clinical Physiology, Karolinska Institutet at Karolinska University Hospital
  1. Correspondence to: H Wahrenberg
  • Accepted 3 March 2005


Insulin resistance is an important pathogenic factor in common metabolic disorders. No easy clinical test exists for predicting the insulin resistance of an individual. We assessed how effectively different anthropometric measurements and biochemical markers used in clinical practice can predict insulin sensitivity.

Participants, methods, and results

We analysed a sample of 2746 healthy volunteers (798 male) from retrospectively collected data. Ages ranged from 18 years to 72 years, body mass index (kg/m2) from 18 to 60, and waist circumferences from 65 cm to 150 cm (see table A on for further data). We determined height, weight, waist circumference (mid-way between the lateral lower ribs and the iliac crest), and hip circumference. Results from analyses of venous plasma for glucose, insulin, lipids, and leptin concentrations were used. We used homoeostasis model assessment (HOMA index) as a measure of insulin sensitivity (plasma glucose (mol/l) x plasma insulin (mU/l)/22.5)—an established test in epidemiological studies.1 We defined insulin resistance as a HOMA score > 3.99, on the basis of a definition for a white population.2

We used multivariate regression models to …

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