Association between the hypertriglyceridemic waist phenotype and diabetes among adults in Puerto Rico

Hypertriglyceridemic waist (HW) phenotype has been proposed as a simple approach to identify patients with excess intra-abdominal adiposity and cardiometabolic abnormalities. This study described the prevalence of HW phenotype and assessed its association with diabetes mellitus (DM). Data from a cross-sectional study using a representative sample of 858 adults residing in the San Juan Metropolitan Area was analyzed. HW phenotype was defined as elevated triglycerides (men: ≥ 177 mg/dL, women: ≥133 mg/dL) and elevated waist circumference (men: ≥90 cm, women: ≥85 cm). Participants were classified into three groups: normal waist circumference and triglycerides (n=284), elevated waist circumference and normal triglycerides (n=335), and elevated waist circumference and triglycerides (n=239). Individuals were classified as having DM if they answered affirmatively to the question of whether a doctor had ever told them they have DM. Logistic regression was used to estimate the adjusted prevalence odds ratio for DM according to HW status. Overall prevalence of HW phenotype was 27.9% (25.4% for males vs. 29.1% for females, p<0.05). After adjusting for age, sex, education, smoking, alcohol consumption, physical activity, family history of DM, BMI, hs-CRP, fibrinogen, and PAI-1, subjects with the HW phenotype were 3.06 (95% CI: 1.39, 6.74) times more likely to self-report DM than subjects who did not have the HW phenotype. The HW phenotype was prevalent and associated to type 2 DM in this population. Future studies should assess the usefulness of the HW phenotype as a screening tool to identify individuals at risk for DM.