Relationship of abdominal obesity measured by DXA and waist circumference with insulin sensitivity in Hispanic and non-Hispanic white individuals: the San Luis Valley Diabetes Study

Abstract

Background: To determine if dual-energy X-ray absorptiometry (DXA) measures of trunk fat, a user-defined abdominal region of interest (ROI) and waist circumference (WC) differ in their association with insulin sensitivity among Hispanics and non-Hispanic whites (NHW) or explain any ethnic differences in insulin sensitivity.

Methods: A cross-sectional study of data collected (1997-98) as part of the longitudinal San Luis Valley Diabetes Study was utilized. There were 664 non-diabetic participants including 349 women (220 NHW, 139 Hispanic) and 305 men (197 NHW, 108 Hispanic), average age 63 years. Measurements included body mass index, WC and DXA measures of total and abdominal fat. Fasting glucose and insulin were used to estimate insulin sensitivity using the QUICKI index. A 2-h oral glucose tolerance test was used to classify participants with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT).

Results: Among women with NGT, Hispanics had lower insulin sensitivity, with DXA trunk fat explaining the most variance in QUICKI and 54% of the ethnic difference in QUICKI after adjusting for total body fat and lean mass. Among men with NGT, there were no differences between Hispanics and NHW in insulin sensitivity or any differences in the association of the abdominal fat measures with insulin sensitivity. Among men and women with IGT, the fat distribution variables explained little variance in QUICKI.

Conclusions: DXA measures of trunk fat provide additional information over WC and the DXA abdominal ROI measure about ethnic differences in insulin sensitivity between older Hispanic and NHW women with NGT.