Relationships of Insulin Action to Age, Gender, Body Mass Index, and Waist Circumference Present Diversely in Different Glycemic Statuses among Chinese Population

INTRODUCTION: To study the influence of different glycemic statuses on the relationship of insulin action to age, gender, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) among Chinese population. METHODS: A total of 35,327 participants (17,456 males and 17,871 females) were included in this nationally representative cross-sectional study. Glycemic status was defined according to the 2010 American Diabetes Association criteria. Fasting insulin was measured by the chemiluminescence method. RESULTS: Insulin and HOMA-IR levels were the highest in newly diagnosed diabetes and were lowest in normal fasting glucose (NFG) (P < 0.001). Insulin and HOMA-IR levels were higher in females (P < 0.001) than in males with previously diagnosed diabetes and impaired fasting glucose (IFG) and NFG, meanwhile decreased with age (P < 0.001) among IFG and NFG participants. As compared with participants with a BMI from 18.5 to 19.9, those in the lowest BMI category (<18.5) had a significantly elevated risk of IR (OR, 1.96; 95% CI, 1.01–3.80), as did those in the higher BMI categories among NFG participants. The risk of IR increased with WC and WHtR, and the response was linear (P < 0.001 for linear trend) for the participants with NFG but not in those with IFG. CONCLUSIONS: Different glycemic statuses significantly affect the relationships of insulin action to age, gender, BMI, WC, and WHtR among Chinese population.