Table 1Characteristics in men (n=1,263) according to TMA/Wt tertiles
Variable |
TMA/Wt tertiles |
P for difference |
P for trend |
Lower (<338.9 cm2/kg) |
Middle (338.9–377.7 cm2/kg) |
Upper (≥377.8 cm2/kg) |
Age, yr |
50.3±10.6 |
50.7±10.1 |
48.3±10.1 |
0.002 |
0.167 |
BMI, kg/m2
|
26.3±3.2 |
24.6±2.4 |
23.8±2.3 |
<0.001 |
<0.001 |
Waist circumference, cm |
91.6±8.0 |
86.6±5.9 |
82.3±6.3 |
<0.001 |
<0.001 |
Visceral fat area, cm2
|
143.6±48.9 |
118.7±40.8 |
88.9±36.3 |
<0.001 |
<0.001 |
SBP, mm Hg |
128.0±13.5 |
124.7±13.7 |
123.0±13.2 |
<0.001 |
<0.001 |
DBP, mm Hg |
83.1±10.2 |
80.5±9.7 |
79.2±9.7 |
<0.001 |
<0.001 |
Total cholesterol, mg/dL |
197.1±35.2 |
199.9±35.8 |
196.7±30.9 |
0.333 |
0.597 |
HDL-C, mg/dL |
48.9±12.2 |
50.7±11.7 |
54.4±12.8 |
<0.001 |
<0.001 |
LDL-C, mg/dL |
122.3±32.8 |
123.9±34.3 |
120.9±28.1 |
0.427 |
0.938 |
Triglycerides, mg/dL |
141.0 (104.0–209.0) |
136.0 (97.0–194.0) |
117.0 (80.0–163.0) |
<0.001 |
<0.001 |
Fasting glucose, mg/dL |
92.0 (86.0–102.0) |
91.0 (84.0–99.0) |
89.0 (83.0–94.0) |
<0.001 |
<0.001 |
Fasting insulin, uIU/mL |
10.3 (7.8–13.7) |
8.7 (6.8–10.9) |
7.5 (6.0–9.8) |
<0.001 |
<0.001 |
HbA1c, % |
5.6 (5.4–5.9) |
5.5 (5.3–5.8) |
5.4 (5.2–5.6) |
<0.001 |
<0.001 |
HOMA-IR |
2.39 (1.74–3.35) |
2.00 (1.52–2.58) |
1.64 (1.30–2.20) |
<0.001 |
<0.001 |
Increased IR, % |
170 (40.4) |
92 (21.9) |
54 (12.8) |
<0.001 |
<0.001 |
C-reactive protein, mg/L |
0.9 (0.5–1.9) |
0.7 (0.4–1.3) |
0.5 (0.3–1.1) |
0.068 |
0.163 |
Hypertension |
188 (44.7) |
132 (31.4) |
110 (26.1) |
<0.001 |
<0.001 |
Pre-diabetes mellitus |
181 (43.0) |
166 (39.4) |
111 (26.4) |
<0.001 |
<0.001 |
Dyslipidemia |
232 (55.1) |
222 (52.7) |
155 (36.8) |
<0.001 |
<0.001 |
Antihypertensive medication |
97 (23.0) |
66 (15.7) |
42 (10.0) |
<0.001 |
<0.001 |
Lipid-lowering medication |
40 (9.5) |
36 (8.6) |
23 (5.5) |
0.075 |
0.029 |
Smoking status |
|
|
|
0.042 |
0.827 |
Non-smoker |
93 (22.1) |
84 (19.9) |
115 (27.3) |
Former smoker |
197 (46.8) |
180 (42.8) |
172 (40.9) |
Current smoker |
131 (31.1) |
157 (37.3) |
134 (31.8) |
Alcohol intake |
|
|
|
0.409 |
0.231 |
Non-drinker |
35 (8.3) |
24 (5.7) |
40 (9.5) |
Former drinker |
21 (5.0) |
25 (5.9) |
27 (6.4) |
Current non-heavy drinker |
200 (47.5) |
208 (49.4) |
186 (44.2) |
Current heavy drinker |
165 (39.2) |
164 (39.0) |
168 (39.9) |
Regular exercise |
270 (64.1) |
267 (63.4) |
295 (70.1) |
0.082 |
0.063 |
Sleep duration, hr/day |
6.9±1.2 |
6.8±1.2 |
7.0±1.1 |
0.096 |
0.601 |
Table 2Characteristics in premenopausal women (n=788) according to TMA/Wt tertiles
Variable |
TMA/Wt tertiles |
P for difference |
P for trend |
Lower (<276.5 cm2/kg) |
Middle (276.5–309.1 cm2/kg) |
Upper (≥309.2 cm2/kg) |
Age, yr |
43.6±6.9 |
43.3±6.9 |
42.0±7.0 |
0.019 |
0.056 |
BMI, kg/m2
|
24.4±3.2 |
22.9±2.6 |
21.6±2.0 |
<0.001 |
<0.001 |
Waist circumference, cm |
80.3±8.1 |
76.3±6.3 |
72.3±5.9 |
<0.001 |
<0.001 |
Visceral fat area, cm2
|
84.20±32.70 |
75.80±30.70 |
58.10±25.6 |
<0.001 |
<0.001 |
SBP, mm Hg |
113.5±12.7 |
110.7±12.6 |
108.6±11.7 |
<0.001 |
0.001 |
DBP, mm Hg |
73.8±9.5 |
72.2±9.0 |
71.1±8.5 |
0.001 |
0.002 |
Total cholesterol, mg/dL |
195.6±32.2 |
191.1±30.6 |
188.9±33.8 |
0.051 |
0.021 |
HDL-C, mg/dL |
60.8±14.1 |
61.4±13.9 |
64.4±15.4 |
0.011 |
0.054 |
LDL-C, mg/dL |
117.8±31.2 |
113.7±27.1 |
108.2±29.8 |
0.002 |
0.004 |
Triglycerides, mg/dL |
93.5 (73.0–123.0) |
85.0 (65.0–110.0) |
79.0 (59.0–107.0) |
<0.001 |
0.004 |
Fasting glucose, mg/dL |
85.0 (80.0–90.0) |
86.0 (80.0–91.0) |
83.0 (79.0–89.0) |
0.002 |
0.696 |
Fasting insulin, uIU/mL |
8.3 (7.0–10.7) |
7.9 (6.6–9.8) |
7.1 (6.0–8.8) |
<0.001 |
0.002 |
HbA1c, % |
5.4 (5.2–5.6) |
5.4 (5.2–5.6) |
5.4 (5.2–5.5) |
0.622 |
0.691 |
HOMA-IR |
1.75 (1.43–2.34) |
1.69 (1.36–2.21) |
1.49 (1.24–1.88) |
<0.001 |
0.009 |
Increased IR, % |
82 (31.3) |
73 (27.8) |
42 (16.0) |
<0.001 |
<0.001 |
C-reactive protein, mg/L |
0.6 (0.4–1.3) |
0.5 (0.3–1.1) |
0.3 (0.2–0.6) |
<0.001 |
0.021 |
Hypertension |
33 (12.6) |
22 (8.4) |
19 (7.2) |
0.085 |
0.035 |
Pre-diabetes mellitus |
55 (21.0) |
57 (21.7) |
45 (17.1) |
0.369 |
0.265 |
Dyslipidemia |
47 (17.9) |
52 (19.8) |
45 (17.1) |
0.721 |
0.805 |
Antihypertensive medication |
14 (5.3) |
6 (2.3) |
8 (3.0) |
0.143 |
0.155 |
Lipid-lowering medication |
3 (1.2) |
7 (2.7) |
6 (2.3) |
0.439 |
0.357 |
Smoking status |
|
|
|
0.787 |
0.537 |
Non-smoker |
237 (90.5) |
238 (90.5) |
230 (87.5) |
Former smoker |
14 (5.3) |
14 (5.3) |
19 (7.2) |
Current smoker |
11 (4.2) |
11 (4.2) |
14 (5.3) |
Alcohol intake |
|
|
|
0.022 |
0.227 |
Non-drinker |
50 (27.0) |
62 (23.0) |
60 (18.0) |
Former drinker |
2 (1.1) |
17 (6.3) |
14 (4.2) |
Current non-heavy drinker |
112 (60.5) |
163(60.4) |
209 (62.8) |
Current heavy drinker |
21 (11.4) |
28 (10.4) |
50 (15.0) |
Regular exercise |
143 (54.6) |
155 (58.9) |
177 (67.3) |
0.011 |
0.003 |
Sleep duration, hr/day |
6.9±1.3 |
7.0±1.2 |
7.0±1.2 |
0.712 |
0.421 |
Table 3Characteristics in postmenopausal women (n=1,476) according to TMA/Wt tertiles
Variable |
TMA/Wt tertiles |
P for difference |
P for trend |
Lower (<261.0 cm2/kg) |
Middle (261.0–292.4 cm2/kg) |
Upper (≥292.5 cm2/kg) |
Age, yr |
57.6±3.9 |
57.0±3.9 |
56.7±4.4 |
0.001 |
<0.001 |
BMI, kg/m2
|
25.3±3.1 |
23.5±2.4 |
22.4±2.0 |
<0.001 |
<0.001 |
Waist circumference, cm |
83.3±8.2 |
79.3±6.8 |
75.1±6.1 |
<0.001 |
<0.001 |
Visceral fat area, cm2
|
115.90±40.40 |
99.30±36.30 |
79.90±30.90 |
<0.001 |
<0.001 |
SBP, mm Hg |
119.9±14.9 |
117.7±14.8 |
114.8±13.2 |
<0.001 |
<0.001 |
DBP, mm Hg |
76.1±9.0 |
75.0±9.1 |
73.2±8.3 |
<0.001 |
<0.001 |
Total cholesterol, mg/dL |
209.1±36.0 |
208.8±35.8 |
203.8±33.2 |
0.031 |
0.155 |
HDL-C, mg/dL |
59.3±13.6 |
59.4±13.6 |
62.2±15.0 |
0.001 |
0.056 |
LDL-C, mg/dL |
128.0±32.0 |
125.7±33.1 |
121.2±31.3 |
0.028 |
0.019 |
Triglycerides, mg/dL |
116.5 (86.0–150.0) |
108.0 (84.0–143.0) |
98.0 (72.0–137.5) |
<0.001 |
0.022 |
Fasting glucose, mg/dL |
89.0 (84.0–95.5) |
88.0 (82.0–94.0) |
87.0 (82.0–93.0) |
<0.001 |
<0.001 |
Fasting insulin, uIU/mL |
8.6 (7.0–11.0) |
8.0 (6.4–10.3) |
7.5 (5.8–9.5) |
<0.001 |
<0.001 |
HbA1c, % |
5.7 (5.4–6.0) |
5.6 (5.4–5.9) |
5.6 (5.4–5.8) |
0.008 |
<0.001 |
HOMA-IR |
1.89 (1.50–2.59) |
1.74 (1.35–2.29) |
1.58 (1.25–2.12) |
<0.001 |
<0.001 |
Increased IR, % |
160 (32.5) |
118 (24.0) |
91 (18.5) |
<0.001 |
<0.001 |
C-reactive protein, mg/L |
0.8 (0.4–1.7) |
0.6 (0.4–1.1) |
0.5 (0.3–0.9) |
<0.001 |
0.011 |
Hypertension |
159 (32.3) |
131 (26.6) |
105 (21.3) |
<0.001 |
<0.001 |
Pre-diabetes mellitus |
238 (48.4) |
199 (40.5) |
214 (43.5) |
0.041 |
0.123 |
Dyslipidemia |
254 (51.6) |
233 (47.4) |
195 (39.6) |
<0.001 |
<0.001 |
Antihypertensive medication |
115 (23.4) |
83 (16.9) |
84 (17.1) |
0.013 |
0.012 |
Lipid-lowering medication |
88 (17.9) |
79 (16.1) |
80 (16.3) |
0.701 |
0.495 |
Smoking status |
|
|
|
0.511 |
0.599 |
Non-smoker |
469 (95.3) |
476 (96.8) |
471 (95.7) |
Former smoker |
15 (3.1) |
12 (2.4) |
11 (2.2) |
Current smoker |
8 (1.6) |
4 (0.8) |
10 (2.0) |
Alcohol intake |
|
|
|
0.002 |
0.012 |
Non-drinker |
205 (36.0) |
174 (35.9) |
121 (28.7) |
Former drinker |
17 (3.0) |
19 (3.9) |
9 (2.1) |
Current non-heavy drinker |
317 (55.7) |
272 (56.1) |
251 (59.5) |
Current heavy drinker |
30 (2.3) |
20 (4.1) |
41 (9.7) |
Regular exercise |
326 (66.3) |
332 (67.5) |
355 (72.2) |
0.109 |
0.046 |
Sleep duration, hr/day |
6.8±1.2 |
6.8±1.2 |
6.8±1.3 |
0.802 |
0.507 |
Table 4Association between TMA/Wt and increased IR in men and premenopausal and postmenopausal women
Subgroup |
No. of participants |
No. of cases (%) |
OR (95% CI) |
Model 1 |
Model 2 |
Model 3 |
Men |
|
|
|
|
|
Upper tertile |
421 |
54 (12.8) |
1.00 |
1.00 |
1.00 |
Middle tertile |
421 |
92 (21.9) |
1.98 (1.37–2.87) |
1.67 (1.14–2.45) |
1.05 (0.70–1.58) |
Lower tertile |
421 |
170 (40.4) |
4.79 (3.38–6.79) |
3.87 (2.70–5.55) |
1.63 (1.10–2.45) |
Per 10 cm2/kg lower |
1,263 |
316 (25.0) |
1.18 (1.14–1.22) |
1.16 (1.12–1.20) |
1.06 (1.02–1.10) |
Premenopausal women |
|
|
|
|
|
Upper tertile |
263 |
42 (16.0) |
1.00 |
1.00 |
1.00 |
Middle tertile |
263 |
73 (27.8) |
2.02 (1.32–3.10) |
1.97 (1.26–3.07) |
1.15 (0.70–1.88) |
Lower tertile |
262 |
82 (31.3) |
2.39 (1.57–3.65) |
1.99 (1.27–3.11) |
1.00 (0.58–1.60) |
Per 10 cm2/kg lower |
788 |
197 (25.0) |
1.12 (1.08–1.17) |
1.10 (1.05–1.15) |
1.01 (0.95–1.06) |
Postmenopausal women |
|
|
|
|
|
Upper tertile |
492 |
91 (18.5) |
1.00 |
1.00 |
1.00 |
Middle tertile |
492 |
118 (24.0) |
1.38 (1.02–1.88) |
1.21 (0.88–1.66) |
0.76 (0.54–1.08) |
Lower tertile |
492 |
160 (32.5) |
2.08 (1.54–2.79) |
1.81 (1.32–2.47) |
0.77 (0.54–1.10) |
Per 10 cm2/kg lower |
1,476 |
369 (25.0) |
1.08 (1.05–1.11) |
1.07 (1.04–1.10) |
0.97 (0.93–1.01) |
Table 5Association between TMA/Wt and increased IR according to BMI categorization in men
BMI |
No. of participants |
No. (%) of cases |
OR (95% CI) |
Model 1 |
Model 2 |
Model 3 |
BMI <25 kg/m2
|
|
|
|
|
|
Upper tertile |
227 |
12 (5.3) |
1.00 |
1.00 |
1.00 |
Middle tertile |
228 |
32 (14.0) |
2.93 (1.46–5.85) |
2.58 (1.26–5.28) |
1.84 (0.88–3.84) |
Lower tertile |
227 |
36 (15.9) |
3.38 (1.70–6.70) |
3.15 (1.57–6.34) |
1.59 (0.75–3.40) |
Per 10 cm2/kg lower |
682 |
80 (11.7) |
1.10 (1.04–1.17) |
1.10 (1.03–1.16) |
1.02 (0.95–1.09) |
BMI ≥25 kg/m2
|
|
|
|
|
|
Upper tertile |
194 |
52 (26.8) |
1.00 |
1.00 |
1.00 |
Middle tertile |
194 |
71 (36.6) |
1.59 (1.03–2.45) |
1.54 (0.98–2.43) |
1.08 (0.66–1.74) |
Lower tertile |
193 |
113 (58.6) |
3.89 (2.53–5.97) |
3.73 (2.39–5.85) |
2.31 (1.42–3.74) |
Per 10 cm2/kg lower |
581 |
236 (40.6) |
1.16 (1.11–1.21) |
1.15 (1.10–1.20) |
1.09 (1.03–1.15) |