The Relationship Between Glucose Intolerance and Blood Pressure, Body Mass Index, and Waist to Hip Ratio in Tehran Urban Population: " Tehran Lipid and Glucose Study"

Glucose intolerance, hypertension, and obesity are important risk factors for cardiovascular diseases. In this study we aim at assessing the association between WHR, BMI, and blood pressure and glucose tolerance status. Of 15000 urban individuals, 3-69 years old, chosen by cluster random sampling in the cross-sectional phase of a longitudinal study in the east of Tehran, 2886 men and 4013 women, between 30-69 years of age, underwent a 2-hour oral glucose tolerance test. Diabetes mellitus (DM) and impaired glucose tolerance (IGT) were defined using WHO criteria. Blood pressure, weight, height, and hip and waist circumferences were measured according to standard protocols, and BMI and WHR werecalculated. 911 subjects (13.2%) had IGT and 372 (5.4%) had diabetes. Obesity (BMI􀁴30 kg/m2) was more common in DM and IGT than healthy individuals (45.1% and 39.1% vs 22.9%, respectively, p<0.001). There was no significant differenceamong the prevalence of overweight (250.8 in females and WHR>0.95 in males) was present in82.7, 75.6 and 53.7% of diabetics, IGT, and normal subjects respectively (p<0.001). In forward stepwise logistic regression adjusted for age and sex, the following variables, in order of entering the model, were significantly associated with DM: age OR=4.4) 95% CI: 3-6.5, p<0.001); Truncal obesity OR=1.8 (95% CI: 1.3-2.4, 0.001); obesity OR=3 (95% CI: 2-4.3, p<0.001); and overweight OR=2 (1.4-2.9, P<0.001). Prevalences of hypertension in DM, IGT, and healthy subjects were 51.9, 39.5, and 18.8%, respectively (p<0.001) and when adjusted for age, sex, BMI, and WHR, all types of glucose disorders were significantly associated with hypertension: IGT OR=1.8 (95% CI: 1.5-2, p<0.001) and DM OR=2.4 (95% CI: 1.9-3, p<0.001).

Conclusion

Hypertension, obesity, and high WHR are more prevalent in ndividuals with diabetes and IGT than in normal population. Furthermore, truncal obesity is more often associated with glucose intolerance than with generalized obesity.