OBJECTIVE: To explore the association between abdominal obesity and insulin resistance in patients with type 2 diabetes. DESIGN: A cross-sectional observational study. SETTING: Primary care in Skara, Sweden. SUBJECTS: A total of 198 men and 186 women with type 2 diabetes who consecutively completed an annual check-up in 1992-1993. MAIN OUTCOME MEASURES: Abdominal obesity was defined according to criteria for the metabolic syndrome using the waist circumference (WC): > 102 cm for men and > 88 cm for women. Insulin resistance was estimated using the Homeostasis Model Assessment (HOMA), and was dichotomized by the 75th percentile (IR). RESULTS: Abdominal obesity was found in 66 men (33%), and in 106 women (57%). Pearson's correlation coefficients between components of the metabolic syndrome and IR were statistically significant for WC, waist-hip ratio, serum triglycerides, and HDL cholesterol, and were higher for WC (0.40) than for waist-hip ratio (0.23) in both genders (p