Distribusi lemak tubuh dan risiko terjadinya diabetes tipe 2

Penelitian ini bertujuan untuk mengetahui indikator apa (indeks massa tubuh, lingkar pinggang dan rasio lingkar pinggang lingkar panggul) yang paling relevan sebagai prediktor diabetes tipe 2 untuk pria dan wanita.

Subyek penelitian dari MONICA Augsburg sebanyak 3.055 pria dan 2.957 wanita, berusia 35-74 tahun, yang tidak menderita diabetes, difollow-up selama lebih dari 9 tahun.

Ternyata baik lemak tubuh maupun lemak perut berhubungan dengan diabetes tipe 2. Maka untuk prediksi diabetes tipe 2 baik pada pria maupun wanita yang terbaik adalah melakukan pengukuran indeks massa tubuh dan lingkar pinggang.

Abstract

Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg Cohort Study

Christa Meisinger, Angela Döring, Barbara Thorand, Margit Heier and Hannelore Löwel American Journal of Clinical Nutrition, Vol. 84, No. 3, 483-489, September 2006 © 2006

Background: It remains controversial whether body mass index (BMI), waist circumference (WC), or waist-hip ratio (WHR) is a better risk predictor of type 2 diabetes.

Objective: The objective was to examine the sex-specific relevance of WC, WHR, and BMI to the development of type 2 diabetes.

Design: The prospective population-based cohort study was based on 3055 men and 2957 women aged 35-74 y who participated in the second (1989-1990) or third (1994-1995) MONICA (Monitoring Trends and Determinants on Cardiovascular Diseases) Augsburg survey. The subjects were free of diabetes at baseline. Hazard ratios (HRs) were estimated from Cox proportional hazards models.

Results: During a mean follow-up of 9.2 y, 243 cases of incident type 2 diabetes occurred in men and 158 occurred in women. Multivariable-adjusted HRs across quartiles of BMI were 1.0, 1.37, 2.08, and 4.15 in men and 1.0, 3.77, 4.95, and 10.58 in women; those of WC were 1.0, 1.15, 1.57, and 3.40 in men and 1.0, 3.21, 3.98, and 10.70 in women; those of WHR were 1.0, 1.14, 1.80, and 2.84 in men and 1.0, 0.82, 2.06, and 3.51 in women. In joint analyses, the highest risk was observed in men and women with a high BMI in combination with a high WC and a high WHR.

Conclusions: Both overall and abdominal adiposity were strongly related to the development of type 2 diabetes. Because there was an additive effect of overall and abdominal obesity on risk prediction, WC should be measured in addition to BMI to assess the risk of type 2 diabetes in both sexes.

Rasio lingkar pinggang-panggul menggambarkan risiko kematian

Penelitian ini bertujuan menilai hubungan antara indeks massa tubuh, lingkar pinggang, dan rasio lingkar pinggang-lingkar panggul terhadap risiko kematian.

Subyek penelitian sebanyak 14.833 orang manula (75 th) dan difollow-up selama hampir 6 tahun.

Kesimpulan penelitian menunjukkan bahwa rasio lingkar pinggang-lingkar panggul berhubungan dengan risiko kematian pada pria dan wanita. Sedangkan indeks massa tubuh dan lingkar pinggang tidak signifikan. Hasil ini mengingatkan pentingnya pengukuran lingkar pinggang dan lingkar panggul.

Abstract

Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death

Gill M Price, Ricardo Uauy, Elizabeth Breeze, Christopher J Bulpitt and Astrid E Fletcher

American Journal of Clinical Nutrition, Vol. 84, No. 2, 449-460, August 2006 © 2006

Background: Guidelines for optimal weight in older persons are limited by uncertainty about the ideal body mass index (BMI) or the usefulness of alternative anthropometric measures. Objective: We investigated the association of BMI (in kg/m2), waist circumference, and waist-hip ratio (WHR) with mortality and cause-specific mortality. Design: Subjects aged 75 y (n = 14 833) from 53 family practices in the United Kingdom underwent a health assessment that included measurement of BMI and waist and hip circumferences; they also were followed up for mortality. Results: During a median follow-up of 5.9 y, 6649 subjects died (46% of circulatory causes). In nonsmoking men and women (90% of the cohort), compared with the lowest quintile of BMI (<23 in men and <22.3 in women), adjusted hazard ratios (HRs) for mortality were <1 for all other quintiles of BMI (P for trend = 0.0003 and 0.0001 in men and women, respectively). Increasing WHR was associated with increasing HRs in men and women (P for trend = 0.008 and 0.0002, respectively). BMI was not associated with circulatory mortality in men (P for trend = 0.667) and was negatively associated in women (P for trend = 0.004). WHR was positively related to circulatory mortality in both men and women (P for trend = 0.001 and 0.005, respectively). Waist circumference was not associated with all-cause or circulatory mortality.

Conclusions: Current guidelines for BMI-based risk categories overestimate risks due to excess weight in persons aged 75 y. Increased mortality risk is more clearly indicated for relative abdominal obesity as measured by high WHR.

What Should We Eat?

Untuk menjaga kesehatan diet seperti apakah yang harus dikonsumsi? Suatu penelitian membuktikan bahwa sebaiknya kita mengkonsumsi diet yang kaya buah dan sayuran, kacang2an, biji2an, lemak tak jenuh dan ikan, serta menghindari lemak jenuh, garam dan daging merah. Semuanya disusun dalam menu sehari2 yang cukup kalori, tidak perlu berlebihan.

Southern Medical Journal. July 2006, Volume 99, Issue 7. © 2006 Southern Medical Association. What Should We Eat? Evidence from Observational Studies, Stephen M. Adams, MD; John B. Standridge, MD.

Abstract: Observational studies provide a wealth of important correlations between diet and disease. There is a clear pattern of dietary habits that is associated with reduced rates of a multitude of common illnesses, including heart attack, cancer, stroke, diabetes, and hypertension. In some cases, interventional studies have proven the benefits of dietary change; in others, there is insufficient evidence to prove causation. Based on the existing evidence, the optimal diet should emphasize fruits and vegetables, nuts, unsaturated oils, whole grains, and fish, while minimizing saturated fats (especially trans fats), sodium, and red meats. Its overall calorie content should be low enough to maintain a healthy weight.