Hypertriglyceridemic waist phenotype is associated with decreased insulin sensitivity and incident diabetes in elderly men

Objective: To investigate the association between hypertriglyceridemic waist (HTGW) and insulin sensitivity (assessed by euglycemic clamp method), and the development of diabetes in a longitudinal community‐based cohort of elderly men without diabetes at baseline. Design and Methods: The present cross‐sectional study comprised 1,026, 70‐year‐old men without diabetes. The gold standard euglycaemic–hyperinsulinaemic clamp technique was used. Six‐year follow‐up on diabetes status were available in n = 667. The HTGW phenotype was defined as having waist circumference ≥ 90 cm, and triglycerides ≥ 2 mmol L −1 . The men were stratified into those having normal WC and TG ( n = 299), one HTGW component ( n = 606), and HTGW ( n = 121). Results: The association between insulin sensitivity and one HTGW component as well as HTGW was highly significant ( P < 0.001) in the whole sample, as well as in individuals with high/low BMI (stratified at ≥25). In longitudinal analyses, participants with HTGW was associated with a more than fourfold increased risk for diabetes (Odds ratio 4.64, 95% CI 1.61–13.4, P = 0.004) compared to those with normal WC and TG. Conclusion: The present study both confirm and extend previous research suggesting that the HTGW‐phenotype portrays an increased glucometabolic risk, also in lean individuals.