{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T19:00:01Z","timestamp":1776884401478,"version":"3.51.2"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["108-2410-H-182 -008 -MY2"],"award-info":[{"award-number":["108-2410-H-182 -008 -MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPD3G0103"],"award-info":[{"award-number":["CMRPD3G0103"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CORPD3J0011"],"award-info":[{"award-number":["CORPD3J0011"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p><jats:bold>Aim:<\/jats:bold> This case\u2013control study aimed to investigate the interrelations of body measurements and selected biomarkers in type 2 diabetes mellitus (T2DM).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We recruited 98 patients with T2DM and 98 controls from 2016 to 2018 in Taiwan. Body measurements were obtained using a three-dimensional body surface scanning system. Four biomarkers related to insulin resistance, adipokines, and inflammation were assayed. A multiple logistic regression model was used to perform multivariable analyses.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Four body measurements, namely waist circumference (odds ratio, OR = 1.073; 95% confidence interval, CI = 1.017\u20131.133), forearm circumference (OR = 1.227; 95% CI = 1.002\u20131.501), thigh circumference (OR = 0.841; 95% CI = 0.73\u20130.969), and calf circumference (OR = 1.25; 95% CI = 1.076\u20131.451), were significantly associated with T2DM. Leptin (OR = 1.09; 95% CI = 1.036\u20131.146) and adiponectin (OR = 0.982; 95% CI = 0.967\u20130.997) were significantly associated with T2DM. Six body measurement combinations, namely body mass index, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, forearm-to-thigh ratio, and calf-to-thigh ratio (CTR), were significantly associated with T2DM. CTR had the strongest linear association with T2DM. Moderating effects of significant biomarkers, namely leptin and adiponectin, were observed. Participants with high leptin-to-adiponectin ratios and in the fourth CTR quartile were 162.2 times more prone to develop T2DM.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> We concluded that a combination of leptin and adiponectin modulated the strength of the association between body measurements and T2DM while providing clues for high-risk group identification and mechanistic conjectures of preventing T2DM.<\/jats:p>","DOI":"10.3389\/fpubh.2021.678681","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T05:30:10Z","timestamp":1627018210000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Higher Leptin-to-Adiponectin Ratio Strengthens the Association Between Body Measurements and Occurrence of Type 2 Diabetes Mellitus"],"prefix":"10.3389","volume":"9","author":[{"given":"Pei-Ju","family":"Liao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Kuo","family":"Ting","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Wen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuo-Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning-I","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuang-Hung","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.2337\/diacare.27.10.2569-a","article-title":"Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Response to Rathman and Giani","volume":"27","author":"Wild","year":"2004","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1001\/jama.2009.726","article-title":"Diabetes in Asia: epidemiology, risk factors, and pathophysiology","volume":"301","author":"Chan","year":"2009","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1152\/physrev.00033.2011","article-title":"Pathophysiology of human visceral obesity: an update","volume":"93","author":"Tchernof","year":"2013","journal-title":"Physiol Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1093\/epirev\/mxm008","article-title":"Comparison of body mass index, waist circumference, and waist\/hip ratio in predicting incident diabetes: a meta-analysis","volume":"29","author":"Vazquez","year":"2007","journal-title":"Epidemiol Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"403","DOI":"10.2147\/DMSO.S34220","article-title":"Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis","volume":"6","author":"Savva","year":"2013","journal-title":"Diabetes Metab Syndr Obesity Targets Ther"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1038\/oby.2010.59","article-title":"Abdominal subcutaneous and visceral adipose tissue and insulin resistance in the Framingham heart study","volume":"18","author":"Preis","year":"2010","journal-title":"Obesity"},{"key":"B7","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1093\/ajcn\/64.4.650","article-title":"Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee","volume":"64","author":"De Onis","year":"1996","journal-title":"Am J Clin Nutr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/0002-9149(94)90676-9","article-title":"Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women","volume":"73","author":"Pouliot","year":"1994","journal-title":"Am J Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3701","DOI":"10.1210\/jc.2009-1779","article-title":"Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study","volume":"95","author":"Preis","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.diabres.2010.02.014","article-title":"Waist-to-thigh ratio and diabetes among US adults: the third national health and nutrition examination survey","volume":"89","author":"Li","year":"2010","journal-title":"Diab Res Clin Pract"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1093\/ajcn\/77.5.1192","article-title":"Associations of hip and thigh circumferences independent of waist circumference with the incidence of type 2 diabetes: the Hoorn Study","volume":"77","author":"Snijder","year":"2003","journal-title":"Am J Clin Nutr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.annepidem.2013.04.004","article-title":"Waist-to-thigh ratio is a predictor of internal organ cancers in humans: findings from a cohort study","volume":"23","author":"Hsu","year":"2013","journal-title":"Ann Epidemiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s00125-004-1637-7","article-title":"Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health ABC Study","volume":"48","author":"Snijder","year":"2005","journal-title":"Diabetologia"},{"key":"B14","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/j.diabres.2015.05.035","article-title":"Adiponectin, leptin, interleukin-6 and HbA1c in the prediction of incident type 2 diabetes: a nested case-control study in Asian Indian men with impaired glucose tolerance","volume":"109","author":"Vinitha","year":"2015","journal-title":"Diab Res Clin Pract"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2248","DOI":"10.2337\/db11-1488","article-title":"Insulin-like growth factor axis and risk of type 2 diabetes in women","volume":"61","author":"Rajpathak","year":"2012","journal-title":"Diabetes"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2912","DOI":"10.1210\/jc.2011-1377","article-title":"Meta-analysis and dose-response metaregression: circulating insulin-like growth factor I (IGF-I) and mortality","volume":"96","author":"Burgers","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"B17","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.annepidem.2005.04.014","article-title":"Waist-to-thigh ratio can also be a better indicator associated with type 2 diabetes than traditional anthropometrical measurements in Taiwan population","volume":"16","author":"Chuang","year":"2006","journal-title":"Ann Epidemiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1038\/oby.2001.61","article-title":"Neck circumference as a simple screening measure for identifying overweight and obese patients","volume":"9","author":"Ben-Noun","year":"2001","journal-title":"Obes Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/S0895-4356(02)00433-X","article-title":"Comparison of three-dimensional anthropometric body surface scanning to waist-hip ratio and body mass index in correlation with metabolic risk factors","volume":"55","author":"Lin","year":"2002","journal-title":"J Clin Epidemiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/6742384","article-title":"Predicting type 2 diabetes mellitus occurrence using three-dimensional anthropometric body surface scanning measurements: a prospective cohort study","volume":"2018","author":"Ting","year":"2018","journal-title":"J Diab Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1046\/j.1365-2796.1997.00235.x","article-title":"Narrow hips and broad waist circumferences independently contribute to increased risk of non-insulin-dependent diabetes mellitus","volume":"242","author":"Seidell","year":"1997","journal-title":"J Intern Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.2307\/2531743","article-title":"Power calculations for matched case-control studies","volume":"44","author":"Dupont","year":"1988","journal-title":"Biometrics"},{"key":"B23","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1001\/archinte.153.2.154","article-title":"The fifth report of the joint national committee on detection, evaluation and treatment of high blood pressure (JNC5)","volume":"153","author":"Program","year":"1992","journal-title":"Arch Int Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1093\/aje\/kwf145","article-title":"Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study","volume":"156","author":"Laaksonen","year":"2002","journal-title":"Am J Epidemiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/S0140-6736(09)60937-5","article-title":"Diabetes in asia","volume":"375","author":"Ramachandran","year":"2010","journal-title":"Lancet"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1210\/jc.2015-3643","article-title":"Association of muscle mass, area, and strength with incident diabetes in older adults: the health ABC study","volume":"101","author":"Larsen","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","first-page":"187","article-title":"Techniques for the measurement of visceral fat: a practical guide","volume":"17","author":"Van der Kooy","year":"1993","journal-title":"Int J Obes"},{"key":"B28","doi-asserted-by":"publisher","first-page":"18565","DOI":"10.1038\/srep18565","article-title":"Neck circumference and incidence of diabetes mellitus over 10 years in the Korean genome and epidemiology study (KoGES)","volume":"5","author":"Cho","year":"2015","journal-title":"Sci Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"265","DOI":"10.2337\/dc18-1178","article-title":"Adipose tissue insulin resistance in youth on the spectrum from normal weight to obese and from normal glucose tolerance to impaired glucose tolerance to type 2 diabetes","volume":"42","author":"Kim","year":"2019","journal-title":"Diab Care"},{"key":"B30","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.metabol.2014.10.015","article-title":"Leptin resistance and diet-induced obesity: central and peripheral actions of leptin","volume":"64","author":"S\u00e1inz","year":"2015","journal-title":"Metabolism"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e1002607","DOI":"10.1371\/journal.pgen.1002607","article-title":"Novel loci for adiponectin levels and their influence on type 2 diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals","volume":"8","author":"Dastani","year":"2012","journal-title":"PLoS Ggenet"},{"key":"B32","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.clnu.2004.04.010","article-title":"Adiponectin, the missing link in insulin resistance and obesity","volume":"23","author":"Gil-Campos","year":"2004","journal-title":"Clin Nutr"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.2337\/diabetes.50.5.1126","article-title":"Circulating concentrations of the adipocyte protein adiponectin are decreased in parallel with reduced insulin sensitivity during the progression to type 2 diabetes in rhesus monkeys","volume":"50","author":"Hotta","year":"2001","journal-title":"Diabetes"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.678681\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T05:30:15Z","timestamp":1627018215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.678681\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,23]]},"references-count":33,"alternative-id":["10.3389\/fpubh.2021.678681"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2021.678681","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,23]]},"article-number":"678681"}}