Baseline Waist Circumference Predicts Weight Change

Eleni Rebelos, from the University of Pisa in Italy, and colleagues analyzed metabolic predictors of spontaneous weight changes in 561 women and 467 men who participated in the Relationship Between Insulin Sensitivity and Cardiovascular Disease study (mean age, 44 years; body mass index [BMI] range, 19 to 44 kg/m²). Insulin sensitivity and beta-cell function were measured and participants were followed for three years.

The investigators found that insulin sensitivity was similar in weight gainers, weight losers (top and bottom 20 percent of BMI changes), or weight-stable individuals in all quartiles of baseline BMI. Neither insulin sensitivity nor any beta-cell function parameter was independently correlated with weight gain, after controlling for center, age, gender, and baseline BMI. This persisted irrespective of whether individuals had normal or impaired glucose tolerance, and did or did not progress to dysglycemia. Weight gainers and losers had significantly higher average baseline BMI (26.1 and 26.6 kg/m², respectively) than weight-stable individuals (24.8 kg/m²).

An independent and positive predictor of weight gain and loss was baseline waist circumference (or equivalently, BMI or weight), with an odds ratio of 1.48 for men and 1.67 for women. An additional independent predictor of weight loss in men was higher insulin sensitivity.

"Neither insulin sensitivity nor insulin secretion predicts spontaneous weight gain. Individuals who have attained a higher weight are prone to either gaining or losing weight regardless of their glucose tolerance," the authors write.

Diabetes, July 2011