Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.     

Prevalence of obesity and metabolic syndrome in Korean adults

We studied the prevalence and trend of obesity and metabolic syndrome in Korean adults aged at least 20 years using Korean National Health Examination and Nutrition Survey data from 1998 and 2001. The prevalence of body mass index (BMI) ≥ 25 kg m^?2 among Korean adults in 2001 was 32.9% in men and 27.4% in women, and the number of Korean men with BMI ≥ 25 kg m^?2 has increased markedly since 1998. A significant positive association between obesity and socioeconomic status was found in Korean men, whereas a significant negative association was identified in Korean women. The prevalence rates of waist circumference (WC) ≥ 90 cm in men and WC ≥ 85 cm in women were 23.4% and 23.1% in 2001 respectively. The prevalence of metabolic syndrome among Korean adults was 15–30% according to various criteria of metabolic syndrome. Future studies are needed to determine the changes in prevalence of obesity and contributing factors for obesity in Koreans.     

Reassessment of the cutoff values of waist circumference and visceral fat area for identifying Japanese subjects at risk for the metabolic syndrome

In the new world-wide criteria for metabolic syndrome (MetS) by the International Diabetes Federation (IDF) in 2006, the Japanese is the only ethnicity in which the recommended waist circumference (WC) cutoff value is higher in women (>or=90cm) than in men (>or=85cm), and its validity appears to be controversial. We investigated the optimal cutoff points for the diagnosis of central obesity in Japanese men and women, using the receiver operating characteristic (ROC) curve analysis for both of WC and visceral fat area (VFA) in 1870 middle-aged Japanese. VFA was superior to WC and Body mass index (BMI) for discriminating the subjects with two or more nonadipose components of MetS. The optimal cutoff points of VFA and WC were 132.6cm(2) and 89.8cm for men and 91.5cm(2) and 82.3cm for women. The stratifications of MetS components more than 1.0 in average occurred more steeply by the accumulation of VFA in women than in men. In conclusion, setting the cutoff points of WC and VFA lower values in women than in men for the definition of central obesity is needed to identify the subjects with MetS in Japanese, as in other Asian populations.     

中国成人多重心血管危险因素聚集的最佳腰围切割点

目的探讨中国成人多重心血管危险因素聚集的最佳腰围切割点。方法分析1994年全国糖尿病普查的15628例年龄≥25岁的中国成人资料。以腰围〈70cm组（每隔5cm分为一组）作为对照,计算其他各组发生多重心血管危险因素的优势比OR值和95％CI。采用ROC曲线分析计算不同腰围水平对多重心血管危险因素聚集识别的敏感性和特异性,以诊断指数（诊断指数=1-假阳性-假阴性）最大的腰围作为最佳切割点。结果无论男性还是女性。胰岛素抵抗、血脂异常、高血压和高血糖的百分比均随着腰围的增加而增加。男性腰围≥85cm、女性腰围≥80cm后发生代谢综合征的OR值显著增加[分别为2．08（95％CI1．80-2．39）和1．66（95％CI1．41-1．97）1。ROC分析显示以上相应腰围切割点具有最佳的敏感性和特异性。结论反映中国成人多重心血管危险因素聚集的男性最佳腰围切割点为85cm、女性为80cm。     

Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study

Objective:Waist circumference (WC) value reflects abdominal adiposity, but the amount abdominal fat that is associated to cardiometabolic risk factors varies among ethnicities. Determination of metabolic abnormalities has not undergone a WC adaptation process in Venezuela. The aim of the study was (1) to determine the optimal WC cutoff value associated with ≥2 cardiometabolic alterations and (2) incorporating this new WC cutoff, to determine the prevalence of abdominal obesity and cardiometabolic risk factors related in Venezuela.Methods:The study was national population-based, cross-sectional, and randomized sample, from 2014 to 2017. To assess performance of WC for identifying cardiometabolic alterations, receiver operating characteristics curves, area under the curve (AUC), sensitivity, specificity, and positive likelihood ratios were calculated.Results:Three thousand three hundred eighty-seven adults were evaluated with mean age of 41.2 ± 15.8 years. Using the best tradeoff between sensitivity and specificity, WC cutoffs of 90 cm in men (sensitivity = 72.4% and specificity = 66.1%) and 86 cm in women (sensitivity = 76.2% and specificity = 61.4%) were optimal for aggregation of ≥2 cardiometabolic alterations. AUC was 0.75 in men and 0.73 in women using these new cutoffs. Prevalence of abdominal obesity and metabolic syndrome was 59.6% (95 CI; 57.5-61.7) and 47.6% (95 CI; 45.2-50.0), respectively. Cardiometabolic risk factors were associated with being men, higher age, adiposity, and living in northern or western regions.Conclusion:The optimal WC values associated with cardiometabolic alterations were 90 cm in men and 86 cm in women. More than half of the Venezuelan population had abdominal obesity incorporating this new WC cutoff.Key words: Abdominal obesity, Adiposity, Metabolic syndrome, Venezuela, Waist circumference     

Obesity and metabolic syndrome in Korea

In Korea, a person with a body mass index (BMI) ≥25 kg/m(2) is considered obese, and a person with a BMI ≥30 kg/m(2) is classified as severely obese. Central obesity is defined as a waist circumference ≥90 cm for Korean men and ≥85 cm for Korean women. Recent epidemiologic data show that the prevalence of severe obesity and metabolic syndrome is steadily increasing. These epidemics increased morbidity and mortality of type 2 diabetes, cardiovascular diseases, and obesity-related cancers such as breast, colorectal, and other cancers in Korea. Decreased physical activity, increased fat and alcohol consumption, heavy smoking, and stress/depressed mood are the primary modifiable life-style risk factors for Koreans. Recently, public health interventions to encourage life-style changes have shown promising results in reducing the prevalence of severe obesity and metabolic syndrome.     

Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity

OBJECTIVE: To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians. DESIGN: Analysis of data from multisite cross-sectional epidemiological studies in north India.Subjects:In all, 2050 adult subjects >18 years of age (883 male and 1167 female subjects). MEASUREMENTS: Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol. RESULTS: In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI >21 kg/m(2). WC levels of > or =90 and > or =80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of > or =25 kg/m(2). The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study. CONCLUSION: We propose the following WC action levels for adult Asian Indians: action level 1: men, > or =78 cm, women, >/=72 cm; and action level 2: men, > or =90 cm, women, > or =80 cm.     

我国中年人群向心性肥胖和心血管病危险因素及其聚集性

目的 分析在中国人群中,反映向心性肥胖的指标－－腰围与心血管病危险因素及其聚集性的关系。并探讨中国人群适宜的腰围切点。方法 分析数据来自1993－1994年对14组中年（35－59）岁人群进行的抽样调查,职业包括产业工人,农民,城市居民和渔民,地点分布于东北,华北,华东,华南,西南和中部。调查项目均采用国际标准化方法,由合作中心进行统一培训,考核和质量控制。资料完整可供分析16466人。结果 显示中国人群腰均值男,女性均小于西方人群,北方高于南方,城市居民和工人高于农民,将腰围从＜65cm至大于等于100cm,每5cm进行分层,可见无论男性或女性,高血压,高血清总胆固醇,低高密度脂蛋白胆固醇和空腹血糖升高的检出率及具有2个及以上危险因素的聚集率均随腰围的增大而逐步上升。危险因素聚集的年龄调整比值比（OR值）男性和女性分别增高7．8倍和8．5倍,以不同腰围切点计算对于检出危险因素聚集的敏感度和特异度,显示男性腰围大于等于85cm,检出危险因素聚集的敏感度为54．2％,特异度为77．3％,女性腰围大于等于80cm,相应的敏感度和特异度为59．8％和70．3％,较其他各切点为优,结论 研究表明,向心性肥胖的程度和心血管病危险因素升高及聚集密切相关,应重视对以腹部肥胖为特征的向心性肥胖进行防治,;男性腰围应控制在85cm以下,女性应控制在80cm以下。     

Waist circumference cut-off points for identification of abdominal obesity among the tunisian adult population

AIMS: Waist circumference (WC) is a convenient measure of abdominal adipose tissue. It itself is a cardiovascular disease (CVD) and diabetes-risk factor and is strongly linked to other CVD risk factors. There are, however, ethnic differences in the relationship of WC to the other risk factors. The aim of this study was to determine the optimal cut-off points of WC and body mass index (BMI) at which cardiovascular risk factors can be identified with maximum sensitivity and specificity in a representative sample of the Tunisian adult population and to investigate any correlation between WC and BMI. METHODS: We used a sample of the Tunisian National Nutrition Survey, a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. WC, BMI, blood pressure and fasting blood measurements (plasma glucose, total cholesterol, triglycerides) were recorded. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of WC and BMI to identify with maximum sensitivity and specificity the detection of high blood pressure, hyperglycaemia, high blood cholesterol and hypertriglyceridaemia. RESULTS: ROC curve analysis suggested WC cut-off points of 85 cm in men and 85 cm in women for the optimum detection of high blood pressure, diabetes and dyslipidaemia. The optimum BMI cut-off points for predicting cardiovascular risk factors were 24 kg/m(2) in men and 27 kg/m(2) in women. The cut-off points recommended for the Caucasian population differ from those appropriate for the Tunisian population. The data show a continuous increase in odds ratios of each cardiovascular risk factor, with increasing level of WC and BMI. WC exceeding 85 cm in men and 79 cm in women correctly identified subjects with a BMI of >/=25 kg/m(2), sensitivity of >90% and specificity of >83%. CONCLUSIONS: Based on the ROC analysis, we suggest a WC of 85 cm for both men and women as appropriate cut-off points to identify central obesity for the purposes of CVD and diabetes-risk detection among Tunisians. WCs of 85 cm in men and 79 cm in women were the most sensitive and specific to identify most subjects with a BMI >/=25 kg/m(2).     

The relationship between asthma symptoms and anthropometric markers of overweight in a Hispanic population.

BACKGROUND: Previous studies have revealed the relationship between asthma and obesity, but the relationship with other markers of overweight and obesity has not yet been investigated. OBJECTIVE: To establish the relationship between asthma symptoms and simple anthropometric indexes (BMI, waist circumference (WC), and waist-to-hip ratio (WHR)) as markers of overweight in an adult Hispanic population. METHODS: The data were obtained from the PRIT (Prevalence of Cardiovascular Risks in General Hospital Workers) 2001 survey. The participants were workers at the Hospital General de México in Mexico City and included 135 men and 398 women aged 43.8 +/- 11.9 and 43.0 +/- 10.5, respectively. Odds ratios for asthma symptoms at different BMI, WC, and WHR cutoff points associated with excessive weight were calculated. The likelihood ratios for having asthma symptoms in participants with various cutoff values of BMI, WC, and WHR also were calculated. RESULTS: Asthma symptoms were not related to anthropometric markers of overweight or obesity in men, while they were associated in women with WC cutoff levels of 80 and 85 cm, and BMI of 25 and 27 kg/m2. No level of WHR was related to asthma symptoms in women. In women, the likelihood ratio for asthma symptoms increased proportionally from WC levels of 73.5 cm up to 86 cm, while this risk increased significantly from BMI levels of 22 up to 29 kg/m2. CONCLUSION: Overweight as assessed by BMI and WC (but not WHR) was related to asthma symptoms in women in the studied population.     

Optimal cutoff point of waist circumference and use of home blood pressure as a definition of metabolic syndrome: the Ohasama study

BACKGROUND: Self-measured blood pressure (BP) at home (HBP) has a stronger predictive power for cardiovascular mortality and morbidity than casual-screening BP (CBP). No studies have evaluated the clinical significance of self-measured HBP for diagnosing metabolic syndrome (MS). Eight scientific associations recently defined MS for the Japanese population. However, this definition remains controversial, especially with respect to the cutoff value of waist circumference (WC) being higher in women than in men. METHODS: The: participants of this population-based survey were the 395 residents (> or =35 years of age) of Ohasama, a rural Japanese community. They measured HBP and underwent the oral glucose tolerance test between the years 2000 and 2006. We calculated the optimal cutoff values of WC required to diagnose MS, and examined the association of HBP with metabolic risk-factor clustering using multivariate analyses. RESULTS: Receiver operation characteristic analysis indicated that the optimal WC cutoff values for identifying clusters of metabolic risk factors were 87 and 80 cm in men and women, respectively. Elevated HBP was significantly associated with the clustering of metabolic risk factors but CBP was not.CONCLUSION:The appropriate WC cutoff value in the current MS criteria for Japanese women would be 80 cm. We suggest that HBP would be useful when considering a diagnosis of MS. The association between MS determined using HBP and the prognosis of cardiovascular diseases (CVDs) requires further investigation.     

Obesity indices and cardiovascular risk factors in Thai adults

OBJECTIVE: To examine the relationship of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) with cardiovascular risk factors and diabetes in Thai population. DESIGN: A national cross-sectional survey of cardiovascular risk factors. SUBJECTS: Five thousand and three hundred five Thai adults aged > or =35 years. MEASUREMENTS: Body weight, height, waist and hip circumference and cardiovascular risk factors including blood pressure, total plasma cholesterol, high-density lipoprotein, triglyceride and fasting plasma glucose were measured. Age- and sex-specific means and prevalence of cardiovascular risk factors were calculated and compared among anthropometric measurements. RESULTS: There were increasing trends of severity of cardiovascular risk factors and prevalence of morbidity conditions across increasing levels of BMI, WC, WHpR and WHtR categories. For age group > or =65 years, WC, WHpR and WHtR provided more consistent association with cardiovascular risk factors than BMI. Area under the curve indicated that measurement of central obesity could predict cardiovascular risk better than BMI. The optimal cutoff points for anthropometric measurements were in line with the Asia-Pacific recommendation; however, similar cutoff point for men and women between 82 and 85 cm was observed. CONCLUSION: Central obesity indices were slightly better associated with cardiovascular risk factors compared to BMI in Thai adults aged > or =35 years.     

Optimal cut points of waist circumference (WC) and visceral fat area (VFA) predicting for metabolic syndrome (MetS) in elderly population in the Korean Longitudinal Study on Health and Aging (KLoSHA)

Optimal cut points of central obesity identifying subjects at risk for MetS were proposed ethnic-specifically, but have not been established yet. Of particular interest are the values for elderly persons, which have not been identified previously. We investigated the appropriate cut points of WC and VFA for elderly in a community-based cohort in Korea. We recruited 294 men and 313 women aged 65 or over who participated in the KLoSHA. A receiver operating characteristic (ROC) curve analysis was used to estimate the optimal cut points of WC and VFA indicative of MetS. The optimal cut points for predicting MetS were 87 cm for WC, 140 cm(2) for VFA in men, and 85 cm for WC, 100 cm(2) for VFA in women with the Youden index. Similar cut points were obtained with the closest-to-(0, 1) criterion except for VFA in men, which was 122 cm(2). When adjusted for age, exercise, smoking, and alcohol consumption, men with ≥122 cm(2) and women with ≥100 cm(2) of VFA had a higher risk of MetS than subjects with lower values. The cut points of VFA and WC at risk for MetS were higher in men than women. In this community-based elderly cohort, the optimal cut points of WC at risk for MetS were lower than the Western criteria. Compared with the cut points in middle-aged Koreans, the cut points for elderly were lower in men and similar in women.     

Association between simple anthropometric indices and cardiovascular risk factors.

OBJECTIVE: To identify which of the three simple anthropometric indices, body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC), best predicts cardiovascular risk factors, and to determine if the association between the anthropometric indices and cardiovascular risk factors varies with gender. DESIGN AND METHODOLOGY: A cross-sectional population-based survey was carried out during 1995-1996. One thousand and ten Chinese people (500 men and 510 women) aged 25-74 y were recruited as subjects for the study. Metabolic profiles and anthropometric indices were measured. RESULTS: Partial correlation and co-variance analyses showed that WC exhibited the highest degree of association with almost all of the studied metabolic profiles for both men and women. We observed significant gender differences in the association between central or general obesity with cardiovascular risk factors. BMI had an independent and significant association with metabolic risks in men, but not in women, whereas WHR was more strongly correlated with metabolic risks for women than for men. Logistic regression analysis further confirmed the magnitude of the association between the obesity indices and metabolic risks. Among the studied metabolic variables, serum insulin showed the highest degree of association with the obesity indices, followed by plasma glucose, triglyceride, HDL and blood pressure. Total cholesterol and LDL-cholesterol had a small but significant correlation with obesity. No threshold values in the relation between either the anthropometric indices and metabolic values, or with hypertension, diabetes and dislipidemia were observed. CONCLUSION: The association of central or general obesity and metabolic syndrome varied with gender. In addition, the useful anthropometric predictors for cardiovascular risk factors were BMI and WC for men, and WC and WHR for women.     

Urgency of reassessment of role of obesity indices for metabolic risks

The definition of metabolic syndrome places emphasis on health care for persons at risk. However, whether an obesity index should be a mandatory component of the definition and whether obesity indices can identify metabolic risks satisfactorily require further exploration. Therefore, we investigated the effectiveness of various anthropometric obesity indices in identifying the clustering of 2 or more American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHLBI)/International Diabetes Federation (IDF)-defined metabolic risk factors (hypertension, hyperglycemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol) for metabolic syndrome and those of other metabolic risk factors (high low-density lipoprotein cholesterol, hyperuricemia, high γ-glutamyltransferase, fatty liver) in 6141 men and 2137 women. The anthropometric indices were the following: (1) for both sexes—various levels of waist-to-height ratio (WHtR) including 0.5 and body mass index (BMI) of 23 and 25 kg/m²; (2) for men and women individually—waist circumference (W) 90/80 cm (AHA/NHLBI/IDF for ethnic groups), W 85/90 cm (Japan Society for the Study of Obesity), and combined W and BMI: W 85/90 cm and/or BMI 25 kg/m² (Japanese government). The results showed the following: (1) The optimal value for WHtR was 0.5 for AHA/NHLBI/IDF-defined risk factors and approximately 0.5 for other risk factors in both sexes. (2) The sensitivities of various proposed obesity indices for identifying clustering of defined and other risk factors varied between 74.4% (WHtR 0.5) and 36.3% (BMI 25) and between 80.5% (WHtR 0.5) and 43.7% (BMI 25) in men, and varied between 65.6% (WHtR 0.5) and 16.8% (W 90 cm) and between 82.3% (WHtR 0.5) and 28.2% (W 90 cm) in women. Because the sensitivities of many anthropometric indices were very low, a reassessment of the effectiveness of obesity indices in evaluating metabolic risks and especially their suitability as a single mandatory component of metabolic syndrome is urgently needed. However, WHtR 0.5 provides a very useful algorithm for screening persons at risk.     

Associations of obesity measures with metabolic risk factors in a community-based population in Japan.

BACKGROUND: The association of obesity measures (ie, body mass index (BMI), waist circumference (WC) and waist-to hip ratio (WHR)) with metabolic risk factors in community-based populations has not been well studied. METHODS AND RESULTS: In the present study 759 men and 1,255 women aged between 30 and 79 years, without histories of stroke or coronary heart diseases, were dichotomized at the medians of BMI-WHR, WC-WHR and BMI-WC. The accumulation of 4 metabolic risk factors (risk _ sum) were examined: high blood pressure (> or =130/85 mmHg or on antihypertensive therapy); high triglycerides (> or =170 mg/dl); low high-density lipoprotein-cholesterol (<40 mg/dl); and impaired glucose tolerance (hemoglobin A1c > or =5.6% or on antidiabetic therapy). BMI and WC correlated well in both men (r=0.871) and women (r=0.874). All 3 obesity measures related with the metabolic risk factors. The area under the receiver-operating characteristic curve for BMI, WC and WHR to predict the risk _ sum > or =2 for men was 0.683, 0.709, and 0.700, respectively, and 0.715, 0.739, and 0.746, respectively, for women. CONCLUSIONS: BMI may be used instead of WC if the latter is not available. When WC is measured, hip circumference also should be measured because the WHR may be the most valuable measure of obesity.     

Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors

OBJECTIVE: To compare the value of body fat mass (%FM) to indirect measures of general (body mass index (BMI)) and central adiposity (waist circumference (WC); waist-to-height ratio (WC/ht)) for the prediction of overweight- and obesity-related metabolic risk in a study population with a high prevalence of metabolic syndrome (MSX). METHODS: BMI, WC, WC/ht, body composition (by air-displacement plethysmography) and metabolic risk factors: triglycerides, cholesterol, HDL-cholesterol (HDL-C), uric acid, systolic blood pressure (BPsys), insulin resistance by homeostasis model assessment (HOMA-IR) and C-reactive protein (CRP) were measured in 335 adults (191 women, 144 men; mean age 53 +/-13.9 years, prevalence of MSX 30%). RESULTS: When compared with BMI and WC, %FM showed weaker associations with metabolic risk factors, except for CRP and BPsys in men. In women, HDL-C and HOMA-IR showed the closest correlations with BMI. For all other risk factors, WC or WC/ht were the best predictors in both sexes. Differences in the strength of correlations between an obesity index and different risk factors exceeded the differences observed between all obesity indices within one risk factor. In stepwise multiple regression analyses, WC/ht was the main predictor of metabolic risk in both sexes combined. However, analysis of the area under receiver operating characteristic curves for prediction of the prevalence of >or=2 component traits of the MSX revealed a similar accuracy of all obesity indices. CONCLUSIONS: At the population level, measurement of body FM has no advantage over BMI and WC in the prediction of obesity-related metabolic risk. Although measures of central adiposity (WC, WC/ht) tended to show closer associations with risk factors than measures of general adiposity, the differences were small and depended on the type of risk factor and sex, suggesting an equivalent value of methods.     

Body mass index and waist circumference as determinants of coronary artery disease in Taiwanese adults with type 2 diabetes mellitus

OBJECTIVE: This study examined the association between body mass index (BMI) and waist circumference (WC) and coronary artery disease (CAD) in Taiwanese type 2 diabetic patients. METHODS: A total of 1183 (558 men and 625 women) patients aged 62.4+/-11.6 years were studied. CAD was diagnosed by history or an electrocardiogram by Minnesota codes. RESULTS: The respective cutoffs of BMI and WC as determined by the receiver operating characteristic curves were 24.5 kg/m2 and 90 cm for men, and 25 kg/m2 and 80 cm for women. Distributions of CAD prevalence and multivariate-adjusted odds ratio (MAOR) for BMI cutoffs of 24.5 and 25 kg/m2 were quite similar in men. MAOR for WC above the respective cutoffs for men and women was 1.832 (1.267-2.648) and 1.450 (0.956-2.200, 0.05 or = 25 kg/m2 was 1.759 (1.213-2.551) and 1.471 (1.052-2.058) for men and women, respectively. Patients with BMI> or = 25 kg/m2 and WC > or = 90 cm for men or > or = 80 cm for women had the highest risk of CAD when compared to those without either risk factor, with respective MAOR of 2.053 (1.352-3.118) and 1.698 (1.071-2.691). CONCLUSION: The recommended BMI and WC cutoffs for obesity for Asian adults are associated with CAD in Taiwanese T2DM.     

Relationship between obesity and several cardiovascular disease risk factors in apparently healthy Korean individuals: comparison of body mass index and waist circumference

Recent versions of the criteria for diagnosing the metabolic syndrome have emphasized the superiority of abdominal obesity, as measured by waist circumference (WC), in identifying individuals at increased risk for cardiovascular disease (CVD). On the other hand, there is evidence that body mass index (BMI), an estimate of overall obesity, fulfills this function as effectively as does WC. The present analysis was performed to compare the relative use of these 2 indices of obesity to identify multiple CVD risk factors. The study population consisted of 19584 apparently healthy men and women of Korean ethnicity, and the CVD risk factors measured included fasting plasma concentrations of the following variables: glucose, insulin, total, low-density lipoprotein, and high-density lipoprotein cholesterol, triglycerides, apolipoproteins A-I and B, and high-sensitivity C-reactive protein. The univariate relationships between the 2 indices of obesity and the 9 CVD risk factors were relatively modest (the highest r value was 0.45), but they were all statistically significant, and the magnitude of the relationships between the CVD risk factors and BMI and WC were comparable. When multivariate analysis was performed, adjusting for age and either BMI or WC, each index of obesity continued to have an independent relationship, albeit reduced in magnitude, with the CVD risk factors. These findings suggest that measurements of BMI provide as much clinical insight as do determinations of WC in identifying multiple CVD risk factors in a large population of apparently healthy Korean men and women, and that the use of both indices would provide the most information.     

Cannabinoid Receptor 1 (CNR1) 4895 C/T Genetic Polymorphism was Associated with Obesity in Japanese Men

Aim: The aim of this study was to investigate the association of cannabinoid receptor 1 (CNR1) 4895 C/T gene polymorphism with obesity and obesity-related cardiovascular disease (CVD) risk factors in Japanese.Method: This study included 1,452 Japanese (678 men and 774 women, aged 25 to 74) from rural communities in Shimane Prefecture, Japan.Results: The frequency of the C minor allele of CNR1 4895 C/T polymorphism was 47%. In men, the CC genotype carriers showed significantly greater body mass index (BMI) and waist circumference (WC) values than T allele carriers, even after adjusting for age and medications for hypertension, dyslipidemia and type 2 diabetes. The frequency of obesity (BMI ≥25 kg/m(2)) in CC genotype carriers was significantly greater than in T allele carriers (31.8% vs 21.5%), but the frequency of central obesity (WC ≥85 for men and WC ≥90 cm for women) was not significant by CNR1 4895 C/T genotype. CC genotype carriers of CNR1 4895 C/T showed, in logistic regression analysis, significantly greater odds for obesity than T allele carriers, even after adjustment for age and the above-mentioned medications. Systolic blood pressure (SBP) values were also significantly different between the CC genotype and T allele carriers after controlling for age, medications for hypertension, dyslipidemia, and type 2 diabetes, and BMI or WC.Conclusion: This study supports the association of CNR1 4895 C/T with interindividual differences in obesity in men.