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PubMed1999

Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses' Health Study.

This study examined prospectively the associations of waist circumference and waist:hip circumference ratio with risk of breast cancer. A total of 47,382 US registered nurses who reported their waist and hip circumferences in 1986 were followed up through May 1994 for identification of incident cases of breast cancer. During 333,097 person-years of follow-up, 1,037 invasive breast cancers were diagnosed. In proportional hazards analyses, waist circumference was nonsignificantly related to risk of premenopausal breast cancer but was significantly associated with postmenopausal breast cancer after adjustment for established breast cancer risk factors (for the highest quintile of waist circumference vs. the lowest, relative risk (RR) = 1.34; 95% confidence interval (CI): 1.05, 1.72). When the analysis was limited to postmenopausal women who had never received hormone replacement therapy, a stronger positive association was found (RR = 1.88; 95% CI: 1.25, 2.85). After the data were further controlled for body mass index, the positive association was only slightly attenuated (RR = 1.83; 95% CI: 1.12, 2.99). Among past and current postmenopausal hormone users, no significant associations were found. Similar but slightly weaker associations were observed between waist:hip ratio and breast cancer risk. These data suggest that greater waist circumference increases risk of breast cancer, especially among postmenopausal women who are otherwise at lower risk because of never having used estrogen replacement hormones.

Abdomen↗
PubMed2002

[A discussion on utility and purposed value of obesity and abdomen obesity when body mass index, waist circumference, waist to hip ratio used as indexes predicting hypertension and hyper-blood glucose].

OBJECTIVE: Discussion on utility and purposed value of obesity and abdomen obesity when body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) used as indexes predicting hypertension, hyper-blood glucose, and both clusters, to provide scientific basis for the decision on the indexes and their cut-off points of obesity and abdomen obesity in Chinese people. METHODS: Using the data of diabetes mellitus (DM) from epidemiological studies carried out in 11 provinces/autonomous regions/municipalities of China from July 1995 to June 1997. Partial relative analysis, logistic multi-factors regression analysis, interaction analysis were used. Relative risk (RR), attributable risk proportion (ARP) and population attributable risk proportion (PARP) of hypertension, hyper-blood glucose, and the both cluster as BMI, WC, WHR with the different cut off points were analysed. RESULTS: 1) The correlations between BMI, WC and blood pressure, blood glucose were better than the WHR. 2) After adjusted by age, sex, occupation leisure physical activity, education degree and the family history of DM, the results suggested that BMI, WC, WHR were important predictive factors, with relative importance as BMI > WC > WHR. 3) There were augment interactions on BMI, WC and WHR with hypertension, hyper-blood glucose, with the interaction of BMI and WC in particular. Their pure attributable interaction proportion were from 5.95% to 29.34%. 4) The values of RR were about 2.5 when BMI >/= 23, >/= 24 and >/= 25, suggesting the relationship with exposure factors and diseases were with medium and high maleficent extent. Their ARP were from 0.580 to 0.623 with PARP from 0.259 to 0.425. The values of RR were from 2.06 to 3.08 as WC >/= 85 cm in males, WC >/= 80 cm in females while WC >/= 90 cm in males, WC >/= 80 cm in females, which suggested that the relationship with exposure factors and diseases were in medium and high maleficent extent. Their ARP were from 0.515 to 0.676 while PARP from 0.241 to 0.431. CONCLUSIONS: Since the maleficent extent of exposure factors to diseases, the acceptability for overweight and obesity in population, and the prevention and care for overweight and obesity were just in the introduction stage in China. The utility value of predicted hypertension, hyper-blood glucose in BMI and WC seemed to be better then in WHR. We suggested that BMI used as the obesity index, with the diagnostic cut-off point BMI >/= 24. WC as the abdomen obesity index. The diagnostic cut-off points are suggested to be WC >/= 85 cm in males, and WC >/= 80 cm in females.

Adult↗
PubMed2000

Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3-19 y.

BACKGROUND: A central fat pattern has adverse health implications in both children and adults. Because adiposity tracks from childhood into adulthood, the ability of simple anthropometric techniques to correctly measure truncal adiposity in childhood needs to be assessed. OBJECTIVES: We sought to assess the validity of waist circumference, waist-to-hip ratio (WHR), and the conicity index as indicators of trunk fat mass in children and adolescents. DESIGN: Trunk fat mass (kg) was measured with dual-energy X-ray absorptiometry in 278 girls and 302 boys aged 3-19 y. Receiver operating characteristic (ROC) curves and areas under the curves (AUCs) for the ROCs were calculated to compare the relative abilities of the anthropometric measures to correctly identify children with high trunk fat mass (z score for our study population of > or =1). RESULTS: The 80th percentile for waist circumference correctly identified 89% of girls and 87% of boys with high trunk fat mass (sensitivity) and 94% of girls and 92% of boys with low trunk fat mass (specificity). Waist circumference performed significantly better as an index of trunk fat mass than did WHR or the conicity index, as shown by the AUCs in girls and boys, respectively: waist circumference AUCs = 0.97 and 0.97, conicity index AUCs = 0.80 and 0.81, and WHR AUCs = 0.73 and 0.71. Our cutoffs for high trunk fat mass and high waist circumference are provided for both sexes for each year of age. CONCLUSION: Waist circumference provides a simple yet effective measure of truncal adiposity in children and adolescents.

Abdomen↗
PubMed2003

Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults.

OBJECTIVES: To compare body mass index (BMI), waist circumference and waist-hip ratio (WHR) as indices of obesity and assess the respective associations with type 2 diabetes, hypertension and dyslipidaemia. DESIGN AND SETTING: A national sample of 11 247 Australians aged > or =25 years was examined in 2000 in a cross-sectional survey. MAIN OUTCOME MEASURES: The examination included a fasting blood sample, standard 2-h 75-g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity. RESULTS: The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior. CONCLUSIONS: Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age-adjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.

Adult↗
PubMed1997

Body mass index, waist circumference, waist-hip ratio, and glucose intolerance in Chinese and Europid adults in Newcastle, UK.

OBJECTIVE: To compare the prevalence of glucose intolerance (impaired glucose tolerance and diabetes), and its relationship to body mass index (BMI) and waist-hip ratio in Chinese and Europid adults. DESIGN: This was a cross sectional study. SETTING: Newcastle upon Tyne. SUBJECTS: These comprised Chinese and Europid men and women, aged 25-64 years, and resident in Newcastle upon Tyne, UK. MAIN OUTCOME MEASURES: Two hour post load plasma glucose concentration, BMI, waist circumference, and waist-hip ratio. METHODS: Population based samples of Chinese and European adults were recruited. Each subject had a standard WHO oral glucose tolerance test. RESULTS: Complete data were available for 375 Chinese and 610 Europid subjects. The age adjusted prevalences of glucose intolerance in Chinese and Europid men were 13.0% (p = 0.04). Mean BMIs were lower in Chinese men (23.8 v 26.1) and women (23.5 v 26.1) than in the Europids (p values < 0.001), as were waist circumferences (men, 83.3 cm v 90.8, p < 0.001; women, 77.3 cm v 79.2, p < 0.05). Mean waist-hip ratios were lower in Chinese men (0.90 v 0.91, p = 0.02) but higher in Chinese women (0.84 v 0.78, p < 0.001) compared with Europids. In both Chinese and Europid adults, higher BMI, waist circumference, and waist-hip ratio were associated with glucose intolerance. CONCLUSIONS: The prevalence of glucose intolerance in Chinese men and women, despite lower BMIs, is similar to or higher than that in local Europid men and women and intermediate between levels found in China and those in Mauritius. It is suggested that an increase in mean BMI to the levels in the Europid population will be associated with a substantial increase in glucose intolerance in Chinese people.

Adult↗
PubMed2001

A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys.

OBJECTIVE: To comparatively evaluate cut-off points of waist circumference, body mass index and waist to hip ratio with respect to their ability to predict other individual and multiple cardiovascular disease risk factors. DESIGN: Population-based, cross-sectional surveys. SUBJECTS: A total of 9913 men and women aged 18-74, selected using health insurance registries from five Canadian provinces. MEASUREMENTS: Anthropometric measures, other cardiovascular risk factors, receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values. RESULTS: : Waist circumference may be the best single indicator of other individual and multiple cardiovascular risk factors. Optimal cut-off points of all anthropometric measures are dependent on age, sex and the prevalence of the risk factor(s) being considered. For waist circumference, cut-off points of > or =90 cm in men and > or =80 cm in women may be most appropriate for prediction of individual and multiple risk factors in Caucasian populations. CONCLUSION: Health professionals should incorporate the use of waist circumference measurements in their routine clinical examination of adult patients.

Adolescent↗
PubMed2003

A comparative evaluation of waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index as indicators of impaired glucose tolerance and as risk factors for type-2 diabetes mellitus.

UNLABELLED: A number of anthropometric indices is used for evaluation of fat tissue accumulation. It is known, that together with increase of obesity increases prevalence of impaired glucose tolerance (IGT) and diabetes mellitus type 2 (DM 2). The aim of this study was to determine, which of following indices: body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) and waist circumference (WC) is the most suitable for the assessment of glucose tolerance disturbances' risk in clinical practice. MATERIAL AND METHODS: The research involved an examination of 1965 people aged > or = 35 years selected from the Lublin town population. Their body mass, height, waist and hip circumferences were measured. Fasting glicaemia and glucose concentration level in the 120th minute after 75 g glucose oral load were determined in full vein blood. DM 2 and IGT were diagnosed according to the 1985 WHO criteria. The evaluation of receiver operating characteristics (ROC) and Pearson's correlation test were used for statistical analysis. RESULTS: The increase of all the studied indices was correlated with the increase of glicaemia, especially after an oral glucose load. The weakest correlation was shown by WHR. WC showed the strongest correlation with fasting glicaemia (except for men, where closer relationship with BMI was observed). Glicaemia after the load was stronger correlated with BMI and WHtR. A comparison of indices made by the analysis of ROC proved that all of them are characterised by a similar relation with the studied diseases. The indices in question showed significantly weaker relation with IGT than with DM 2. WHtR proved to have the highest diagnostic value in the IGT risk assessment IGT and WC in the assessment of DM 2. Interval estimation demonstrated a presence of statistically significant differences between WHR and other indices in the ROC distribution for DM2. The best cut-off points suggested higher DM 2 risk we found were: BMI - 29,2 kg/m2, WC - 97 cm, WHtR - O,62, WHR - 0,91 for women and 27,9 kg/m2, WC - 99 cm, WHtR - O,57, WHR - 0,97 for men. CONCLUSIONS: All the studied indices have a similar value for DM 2 risk assessment. Waist circumference (WC) is especially noteworthy for the family doctor's practice both because of its high diagnostic precision and exceptional simplicity of its determination. The cut-off points of the studied indices should be differentiated according to sex.

Adult↗
PubMed2003

Waist circumference, waist-to-hip ratio and body mass index as predictors of adipose tissue compartments in men.

BACKGROUND: The accumulation of fat in visceral and posterior subcutaneous adipose tissue compartments is highly correlated with the metabolic abnormalities that contribute to increased risk of diabetes mellitus and cardiovascular disease. AIM: To determine which of waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) was the best predictor of intraperitoneal and posterior subcutaneous abdominal adipose tissue mass in men. METHODS: We studied 59 free-living men with a wide range of BMI. WC, WHR and BMI were determined using standard methods. Intraperitoneal, retroperitoneal, anterior subcutaneous and posterior subcutaneous abdominal adipose tissue masses (IPATM, RPATM, ASAATM and PSAATM, respectively) were quantified using magnetic resonance imaging. RESULTS: In univariate regression analysis, WC, WHR and BMI were all significantly and positively correlated (all p < 0.05) with IPATM, RPATM, ASAATM and PSAATM. To assess the relative strength of these associations, we used non-nested regression models. There was no significant difference between WC and WHR in predicting IPATM and RPATM; WC was a stronger predictor of ASAATM (p < 0.001) and PSAATM (p < 0.001) than WHR; WC was also a stronger predictor of IPATM (p = 0.042) and RPATM (p = 0.045) than BMI, but the relative strengths of WC and BMI in predicting ASSATM and PSAATM did not different significantly (p > 0.05); there was no significant difference between BMI and WHR in predicting IPATM and RPATM (p>0.05), but BMI was a stronger predictor of ASAATM (p = 0.036) and PSAATM (p < 0.001) than WHR. DISCUSSION: In men WC is the anthropometric index that most uniformly predicts the distribution of adipose tissue among several fat compartments in the abdominal region, there apparently being little value in measuring WHR or BMI.

Abdomen↗
PubMed2006

Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing Study.

OBJECTIVE: Cross-sectional data suggest that obesity, particularly central obesity, may be associated with decreased production of sex steroid hormones in men. However, longitudinal hormone data on men in relation to obesity status are limited. Previous studies have not consistently demonstrated whether sex steroids are associated specifically to body mass index or to measures of central obesity. Our objective was to examine the relation of obesity (body mass index > 30 kg/m2), and of central obesity (waist circumference > 100 cm or waist to hip ratio > 0.95) to longitudinal change in sex steroid hormones in men. DESIGN: Prospective follow-up of a population-based sample of men in Boston. PATIENTS: Nine hundred forty-two (942) men in the Massachusetts Male Ageing Study with complete anthropometry and hormone data at baseline (1987-1989, ages 40-70) and follow-up (1995-1997). MEASUREMENTS: Free and total testosterone (FT and TT), dehydroepiandrosterone sulphate (DHEAS), and sex hormone-binding globulin (SHBG) were assessed using standardized methods. Health behaviours and medical history were obtained by structured interview. Repeated measures regression was used to describe trends in steroid hormones and SHBG in relation to obesity status, adjusting for age, smoking, alcohol, comorbidities, and physical activity. RESULTS: Obesity was associated with decreased levels of total and free testosterone, and of SHBG at follow-up relative to baseline. For any given baseline concentration of TT, FT or SHBG, follow-up levels were lowest among men who remained obese or who became obese during follow-up. This was true for all three indices of obesity. Central adiposity was associated with lower DHEAS levels at follow-up, while elevated body mass index was not. CONCLUSIONS: Obesity may predict greater decline in testosterone and SHBG levels with age. Central adiposity may be a more important predictor of decline in DHEAS than is body mass index.

Adult↗
PubMed2006

Recent trends in waist circumference and waist-height ratio among US children and adolescents.

OBJECTIVES: Abdominal obesity may be a better predictor than overall obesity for the risk of cardiovascular disease and type 2 diabetes. Waist circumference and waist-height ratio are 2 simple, yet effective, surrogate measures of abdominal obesity. We sought to examine the recent trends in mean waist circumference and waist-height ratio and prevalence of abdominal obesity among children and adolescents aged 2 to 19 years in the United States. METHODS: Representative samples of the civilian, noninstitutionalized US population from the National Health and Nutrition Examination Survey conducted during 4 time periods, 1988-1994 (ie, National Health and Nutrition Examination Survey III), 1999-2000, 2001-2002, and 2003-2004, were examined to estimate the mean waist circumference and waist-height ratio of boys and girls in 4 different age groups. Data from the 3 most recent National Health and Nutrition Examination Surveys were combined to establish a National Health and Nutrition Examination Survey 1999-2004 category. RESULTS: Categorized by age group, the unadjusted mean waist circumference for boys increased between National Health and Nutrition Examination Survey III and National Health and Nutrition Examination Survey 1999-2004 from 50.7 cm (aged 2-5 years), 61.9 cm (aged 6-11 years), 76.8 cm (aged 12-17 years), and 81.3 cm (aged 18-19 years) to 51.9, 64.5, 79.8, and 86.6 cm, respectively. During the same time periods and within the same age groups, the unadjusted mean waist circumference for girls increased from 51.0, 61.7, 75.0, and 77.7 cm to 51.8, 64.7, 78.9, and 83.9 cm, respectively. The relative change in waist-height ratio was similar to waist circumference at each age group for both boys and girls. Using the 90th percentile values of waist circumference for gender and age, the prevalence of abdominal obesity increased by 65.4% (from 10.5% to 17.4%) and 69.4% (from 10.5% to 17.8%) for boys and girls, respectively. CONCLUSIONS: Mean waist circumference and waist-height ratio and the prevalence of abdominal obesity among US children and adolescents greatly increased between 1988-1994 and 1999-2004.

Adolescent↗
PubMed2003

Which method should be used to determine the obesity, in patients with coronary artery disease? (body mass index, waist circumference or waist-hip ratio).

OBJECTIVE: To determine body mass index (BMI), waist circumference and waist-hip ratio (WHR) in cases with angiographically established coronary artery disease (CAD) and to compare the obesity degrees established according to the ranges determined by the International Guidelines Committees for BMI, waist circumference and WHR. DESIGN: Cross-sectional, observational study. SUBJECTS: A total of 617 consecutive cases (516 males, mean age: 57.2+/-10.8 y) with CAD who underwent their first coronary angiography between January 2000 and May 2000. MEASUREMENTS: Before coronary angiography, their heights, weights, waist and hip circumferences were measured. Waist circumferences, BMI and WHRs were compared both as a whole and also within stratified groups as for sexes and age groups categorized in decades above 40 y of age. RESULTS: Overweight cases comprised approximately half of the patients in both sexes. In males, the percentages of obese cases with respect to BMIs were 15%, while males with action level 2 waist circumferences were detected to be 20%. Obese male patients whose WHRs were >or=0.95 were found to be 51%. In female cases, corresponding percentages of obesity were estimated to be 32, 72 and 86%, respectively. CONCLUSION: In the same patient groups, the prevalence of obesity, defined by BMI, waist circumference and WHR, could vary three-fold. Thus, some patients may not display a diagnosis of obesity. To prevent this possibility the waist circumference is an easy method, which reflects central obesity more accurately.

Adult↗
PubMed2006

[Accuracy of waist circumference and waist-to-hip ratio as predictors of dyslipidemia in a cross-sectional study among blood donors in Cuiabá, Mato Grosso State, Brazil].

This study evaluated the accuracy of anthropometric fat location indices (waist circumference and waist-to-hip ratio) as predictors of dyslipidemia, in addition to defining their respective cut-offs. The sample consisted of 416 healthy male blood donors from 20 to 58 years of age at the Blood Center in Cuiabá, capital of Mato Grosso State, Brazil. Serum lipids were determined through the enzymatic method. Data analysis through the ROC curve identified the best indicator and the cut-off with the largest statistically significant area under the ROC curve. The best cut-off points for waist-to-hip ratio and waist circumference were 0.90 and 85cm, respectively. The area under the ROC curve between waist circumference and high cholesterol/HDL relation included the 0.50 value, so waist circumference could not be considered a predictor of dyslipidemia. The best sensitivity and specificity were in the youngest group. Waist-to-hip ratio was a better predictor of dyslipidemia than waist circumference, although the latter showed better discriminating power to detect hypertriglyceridemia. The most accurate cut-off points were lower than those set by the World Health Organization.

Adult↗
PubMedDate not supplied

Association between menopause status and central adiposity measured at different cutoffs of waist circumference and waist-to-hip ratio.

OBJECTIVE: To assess the association between menopause status and central adiposity measured using two different cutoffs of waist circumference and waist-to-hip ratio, while controlling for body mass index and other confounding factors. DESIGN: Cross-sectional study of a representative population-based sample of 358 women from Passo Fundo, Southern Brazil. Medical students performed standardized interviews and anthropometric measurements under supervision. Menopause status was categorized as premenopausal for those with no change in menstrual frequency or flow; menopause transition for those who had these changes; and postmenopausal after 12 months of amenorrhea or bilateral oophorectomy. Obesity was defined by body mass index (BMI) equal or greater than 30 kg/m, whereas central adiposity was defined as a waist circumference equal or greater than 80 or 88 cm and a waist-to-hip-ratio equal or greater than 0.80 or 0.86. RESULTS: The anthropometric assessment showed that compared with postmenopausal women, premenopausal women were taller, had a thinner waist circumference, and had a lower waist-to-hip ratio. Postmenopausal women had five times the chance of having central adiposity than premenopausal women, even after controlling for BMI and other confounding factors. Women in the menopause transition had an increased BMI, but there was no independent association with central obesity. CONCLUSION: Postmenopausal women are at greater risk of central adiposity as detected by both waist circumference and waist-to-hip ratio.

Abdominal Fat↗
PubMed2000

Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index.

BACKGROUND: Visceral adipose tissue is associated with increased risk for cardiovascular disease risk factors and morbidity from cardiovascular diseases. Waist measurement and waist-to-height ratio (WHtR) have been used as proxy measures of visceral adipose tissue, mainly in adults. OBJECTIVE: To validate body mass index (BMI), waist circumference and WHtR as predictors for the presence of cardiovascular disease risk factors in children of Greek-Cypriot origin. SUBJECTS AND METHODS: A total of 1,037 boys and 950 girls with mean age 11.4+/-0.4 y were evaluated. Dependent variables for the study were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholestrol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and systolic (SBP) and diastolic (DBP) blood pressure. RESULTS: When children were divided into two groups according to the 75th percentile for BMI, waist circumference and WHtR, all dependent variables had higher mean values in the highest percentile groups in WHtR groups and almost all variables in BMI and waist circumference groups. Adjusted odds ratios for predicting pathological values of cardiovascular disease risk factors were slightly higher for the highest WHtR group for predicting lipid and lipoprotein pathological values and for the highest BMI groups in predicting high blood pressure measurement. Using stepwise multiple regression analysis to explain the variance of the dependent variables, waist circumference was the most significant predictor for all variables both for boys and girls, whereas BMI had the lowest predictive value for the detection of cardiovascular disease risk factors. CONCLUSION: Waist circumference and WHtR are better predictors of cardiovascular disease risk factors in children than BMI. Further studies are necessary to determine the cutoff points for these indices for an accurate prediction of risk factors.

Adipose Tissue↗
PubMed2004

Waist circumference and waist-to-hip ratio as predictors of serum concentration of lipids in Brazilian men.

OBJECTIVE: It is unknown whether waist circumference can predict a lipid profile beyond that predicted by body fatness alone, after adjustment for important confounding variables such as smoking, alcohol intake, and physical activity. The purpose of this non-clinical, healthy-subject study was to test this hypothesis. METHODS: Data refer to 416 men, ages 20 to 58 y with a body mass index between 18.5 and 29.9 kg/m(2), who were blood donors living in a Brazilian city. Alcohol consumption, smoking, and physical activity were evaluated by interview; body fat was measured by electrical bioimpedance, and weight, height, and waist and hip circumferences were measured by trained anthropometrists. Multiple linear regression analysis was performed to quantify the association between measurements of fat distribution (waist circumference and waist-to-hip ratio) and the ratio of total cholesterol to high-density lipoprotein cholesterol and triacylglycerols independently of measurements of fatness and potentially confounding factors. RESULTS: Waist circumference was strongly correlated with percentage of body fat (r = 0.90), whereas waist-to-hip ratio was less correlated (r = 0.55). After adjustment for age, percentage of body fat, smoking, alcohol intake, and physical activity, waist circumference was not significantly related to the ratio of total cholesterol high-density lipoprotein cholesterol, whereas the waist-to-hip ratio was strongly associated among the youngest subjects (beta = 3.51, P = 0.005). CONCLUSION: Although several studies have analyzed the association between serum lipids with anthropometric markers, few, including the present one, support waist circumference as a good predictor of lipid profile.

Adult↗
PubMed1999

Waist circumference and waist-to-hip ratio in Turkish adults: interrelation with other risk factors and association with cardiovascular disease.

OBJECTIVE: To investigate the distribution of waist circumference (WC) and waist-to-hip ratio (WHR), their relationships with a number of established risk factors and their relevance to cardiovascular morbidity in a random sample of Turkish general adult population. DESIGN: Cross-sectional population-based study. SUBJECTS: The subjects comprised 958 men and 1014 women, aged 25-74 years. MEASUREMENTS: Waist circumference was measured midway between the lower rib and iliac crest while that of the hip at the level of trochanters. Mean of two blood pressure measurements was used for analysis. Plasma total cholesterol (Cho) and triglyceride (Trg) concentrations were measured by the enzymatic dry method with a Reflotron apparatus. RESULTS: Overall mean WC measured 93+/-12 cm in men, and 88.6+/-13 cm in women. Mean WHR was 0.919+/-0.077 and 0.823+/-0.074, respectively, and a rise by about 0.001 was associated with each year of age. In multiple regression analysis a model was utilized that included age, body mass index (BMI), systolic and diastolic blood pressure (BP), plasma total Cho and Trg and category of smoking. This revealed age, BMI, and Trg as independent determinants of WHR in both genders, and diastolic BP in women alone. Age, BMI, and diastolic BP proved to be independently associated with WC in both genders, while Cho did so in men alone, Trg and systolic BP in women alone. Partial correlation coefficients on univariate analysis between all four variables of blood pressure and plasma lipids and either WC or WHR, controlled for age, were highly significant though moderately weak in both genders. These were stronger in men than in women, and stronger with respect to WC than to WHR. Cigarette smoking men and women had significantly lower WC or WHR than nonsmokers and ex-smokers, though these associations did not prove to be independent. When the relevance of WC and WHR to CHD risk was tested in this cohort (for the age bracket 45-74 years) comprising 138 cases with a clinical diagnosis of CHD, only WHR in women proved to be significantly associated. Odds ratio for a value of >0.845 was 1.6. CONCLUSION: WC and WHR are strongly associated with BMI and age as well as with parameters reflecting insulin resistance such as diastolic blood pressure and plasma triglycerides. WHR was significantly associated with coronary heart disease in Turkish women.

Abdomen↗