R. Rosmond, F. Baghei, G. Holm, et al.
heredity, life experience, personality, and ability to
cope are all involved in the perception of an event
and the meaning attached to it. Moreover, most dis-
eases have multiple causes, including factors such
as genetics and personality. Interest in the potential
influence of personality disorders on anthropome-
try, hormones and metabolism promoted the pre-
sent study in a population sample of women.
es. Moreover, the original SCID II Screen question-
naire (14) does not include the questions regard-
ing antisocial personality disorders compared to
the translated and modified version used in this
study. One additional criterion was added as de-
scribed in Ekselius et al. (14).
Anthropometry. Body weight was measured to the
nearest 0.1 kg, and height was measured to the
nearest 0.01 m. The body mass index (BMI) was cal-
culated as the weight in kilograms divided by the
square of height in meters. The waist (W) circum-
ference was measured half-way between the lower
rib and iliac crest, and the hip (H) circumference
over the widest part in the gluteal region, and the
WHR calculated. The abdominal sagittal diameter
was determined as the distance between the ex-
amination table and the highest point of the ab-
domen in a recumbent position (15).
METHODS
Study population
In the present study, we recruited the subjects from
an ongoing cohort study of women (no.=1137) born
in 1956 on uneven days of the month, and living in
Göteborg (8-10, 13). The study was initiated in
1
996. Based on self-reported waist/hip ratio (WHR)
the following three subgroups, each of 150 women,
were selected for further studies: the lowest
(ꢀ0.738) and the highest values (ꢁ0.895) as well as
women around the arithmetic mean (0.798-0.822).
From November 1997 to December 1998, they
were invited to a health examination at the labora-
tory, and 270 (60%) volunteered to participate.
Women were excluded from the study if they had
Cushing’s syndrome, Addison disease, or were
post-menopausal. All women gave written informed
consent before participating in the study, which was
approved by the Göteborg University Ethics Com-
mittee.
Hormones, glucose, and lipids. The assessment of
cortisol was done by a sampling device called
Salivette (Sarstedt, Landskrona, Sweden), where sali-
vary cortisol concentrations were determined (Orion
Corporation, Espoo, Finland). We gave the partici-
pants one tablet of DEX (Decadron, MSD, Sollen-
tuna, Sweden) of 0.5 mg to be taken at 10:00 h on a
random working day. The following morning the par-
ticipants collected saliva using the Salivette. ACTH
(Nichols Institute Diagnostics, San Juan Capistrano,
CA, U.S.A.), corticosteroid-binding globulin (Med-
genix Diagnostics, Fleurus, Belgium), prolactin and
follicle-stimulating hormone (Diagnostic Products
Corporation, Los Angeles, CA, U.S.A.), IGF-I (Nichols
Institute Diagnostics, San Juan Capistrano, CA,
U.S.A.), thyroid-stimulating hormone and free thy-
roxine (Abbott Laboratories, Abbott Park, IL, USA)
were analyzed by commercially available RIA kits.
Serum insulin was measured by RIA (Pharmacia &
Upjohn Diagnostics, Uppsala, Sweden), and glucose
in whole blood was determined by the automated
glucose analyzer ESAT 6660 from Eppendorf (16).
Triglycerides, total- and high-density lipoprotein
(HDL) cholesterol were measured with an enzymatic
procedure in a Boehringer Mannheim Cobas Fara II
(Boehringer Mannheim, Germany). Low-density
lipoprotein (LDL) cholesterol was determined using
the Friedewald formula.
Clinical examination
Two physicians (R.R., F.B.) subjected all participants
to a clinical examination by obtaining a restricted
history supplemented by a physical examination
that emphasized detailed investigation of potential
key organ systems. The clinical examination aimed
to disclose the following earlier or current diseases:
myocardial infarction, angina pectoris, stroke, hy-
perlipidemias, hypertension, endocrine disorders,
Type 1 and Type 2 diabetes mellitus.
Study design
The same research technician performed all an-
thropometric and biochemical examinations in the
morning after the participants had been fasting
overnight.
Personality disorders. The Structured Clinical Inter-
view for DSM-III-R, Axis II (SCID II) Screen Question-
naire was used to evaluate PD. This questionnaire
includes 124 questions to be answered “yes” or
Statistical methods. Test if the distribution of a vari-
able has the same location parameter across two
groups was performed with Pitman permutation
test (17, 18). The significance level was based on
the exact distribution of the test statistic, and a
p<0.05 was considered to be significant. We ex-
“
no”. The questions concerning antisocial behav-
ior (no.=23) were excluded due to their offensive
character in order to avoid defect or hostile respons-
160