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Abstract
The objective of the study was to determine whether race plays a role in the relationship between waist circumference and insulin resistance in an African American and white sample of subjects with schizophrenia. A cross-sectional comparison was conducted to determine the relationship between waist circumference and insulin resistance in 55 subjects treated with antipsychotic medication. Each subject underwent an anthropometric assessment of waist and hip circumference, height, weight and body mass index. Laboratory assays were performed to assess insulin resistance by the homeostasis model assessment for insulin resistance (HOMA-IR). Data for fifty-five subjects are reported: white/Caucasian (n=38) and African American (n=17). Mean waist circumference was higher in whites (98 cm±11 cm) compared with African Americans (94 cm±11 cm) but not statistically significant (p=0.181). There was no correlation between waist circumference and insulin resistance calculated by HOMA-IR in the African American subject sample (r=0.05, p=0.853). There was a statistically significant positive correlation between waist circumference and insulin resistance in the white subjects (r=0.66, p≤0.001). After controlling for demographic variables, white subjects had a statistically significant positive correlation between waist circumference and insulin resistance (r=0.623, p=0.00) while African American subjects did not (r=0.022, p=0.944). When age, gender and current antipsychotic agent are controlled for, multiple regression analysis show that waist circumference, race and their interaction term (waist circumference X race) all had significant contributions to the variance of HOMA-IR. Race appeared to be a significant modulator for the relationship between waist circumference and HOMA-IR. The study concludes that race is an important modulator for the relationship between waist circumference and insulin resistance. While waist circumference was an excellent predictor of insulin resistance for white schizophrenia subjects, it was not in the African American schizophrenia population. These findings suggest that predictors in the general population may not be applicable to African American schizophrenia patients receiving atypical antipsychotic medications.
Acknowledgements
This project was supported by an American Psychiatric Association Fellowship Award (BBR), National Institute of Health (NIH/NCRR) Grant 5MO1RR01066-24 (General Clinical Research Center) and a NARSAD New Investigator Award (DCH).