Sun Ha Jee1, Soon Young Lee, Chung Mo Nam, Sang Yon Kim, Miyong T Kim. 1. Department of Epidemiology and Health Promotion, Graduate School of Health Science and Management, Yonsei University, PO Box 8044, Seoul 120-749, Korea. jsunha@yumc.yonsei.ac.kr
Abstract
OBJECTIVE: Research on diabetes mellitus (DM) indicates that people with a low body mass index (BMI) but a high waist-to-hip ratio (WHR) are in a particularly high-risk group. The purpose of this study was to investigate the prevalence of and the effect of smoking on this paradoxical relationship. RESEARCH METHODS AND PROCEDURES: Our study sample consisted of 3450 men and 4250 women who had participated in the Korean Nationwide Health Examination Survey. We divided the study sample into tertiles (low, medium, and high), according to the level of WHR and of BMI, which yielded nine different combinations. Individuals exhibiting so-called paradox A had the highest WHR and the lowest BMI. RESULTS: The prevalence of paradox A was 4.7% for men and 3.8% for women. The overall agreement of WHR and BMI groups was poor [for men: kappa = 0.31 and 95% confidence interval (CI) = 0.29 to 0.34; for women: kappa = 0.39 and 95% CI = 0.37 to 0.42 for women]. The odds ratios for subjects having paradox A were estimated using a logistic regression model after adjusting for age, age(2), height, education, smoking, use of alcohol, and exercise. The risk for paradox A among current smokers was 2.1-fold (95% CI, 1.5 to 3.0) higher for men and 2.5-fold (95% CI, 1.6 to 3.9) higher for women than for nonsmokers, after adjusting for age and covariates. DISCUSSION: Cigarette smoking may increase the risk of paradox A. The findings of this study should be crossvalidated to different populations.
OBJECTIVE: Research on diabetes mellitus (DM) indicates that people with a low body mass index (BMI) but a high waist-to-hip ratio (WHR) are in a particularly high-risk group. The purpose of this study was to investigate the prevalence of and the effect of smoking on this paradoxical relationship. RESEARCH METHODS AND PROCEDURES: Our study sample consisted of 3450 men and 4250 women who had participated in the Korean Nationwide Health Examination Survey. We divided the study sample into tertiles (low, medium, and high), according to the level of WHR and of BMI, which yielded nine different combinations. Individuals exhibiting so-called paradox A had the highest WHR and the lowest BMI. RESULTS: The prevalence of paradox A was 4.7% for men and 3.8% for women. The overall agreement of WHR and BMI groups was poor [for men: kappa = 0.31 and 95% confidence interval (CI) = 0.29 to 0.34; for women: kappa = 0.39 and 95% CI = 0.37 to 0.42 for women]. The odds ratios for subjects having paradox A were estimated using a logistic regression model after adjusting for age, age(2), height, education, smoking, use of alcohol, and exercise. The risk for paradox A among current smokers was 2.1-fold (95% CI, 1.5 to 3.0) higher for men and 2.5-fold (95% CI, 1.6 to 3.9) higher for women than for nonsmokers, after adjusting for age and covariates. DISCUSSION: Cigarette smoking may increase the risk of paradox A. The findings of this study should be crossvalidated to different populations.
Authors: Michael Mangubat; Kabirullah Lutfy; Martin L Lee; Laura Pulido; David Stout; Richard Davis; Chang-Sung Shin; Meghdi Shahbazian; Stephen Seasholtz; Amiya Sinha-Hikim; Indrani Sinha-Hikim; Laura E O'Dell; Alexei Lyzlov; Yanjun Liu; Theodore C Friedman Journal: J Endocrinol Date: 2011-12-02 Impact factor: 4.286
Authors: Kushal Patel; Margaret K Hargreaves; Jianguo Liu; David Schlundt; Maureen Sanderson; Charles E Matthews; Charlene M Dewey; Donna Kenerson; Maciej S Buchowski; William J Blot Journal: Am J Health Behav Date: 2011-09