我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究

目的：确定我国成人适宜的体重指数（BMI）范围和超重肥胖的划分界限。国际生命科学学会中国办事处中国肥胖问题工作组，对国内现有体量指标和相关疾病危险因素的研究数据组织了汇总分析。方法：有13项1990年以后的调查资料人选，共计20－70岁以上成人23972人，有腰围数据者111411人，有血脂和血糖化验数据者8万余人。数据进入分析的人群分布于大陆21个省市、自治区儿台湾。汇总方法是由各负责单位根据统一制定的表格和标准提供数据，汇总分析中心进行核对、汇总和统计分析。结果；高血压、糖尿病、血清总胆固醇升高、高密度脂蛋白胆固醇过低、甘油三酯升高和危险因素聚集（一个人具有2个及以上危险因素）的现患率均随BMI或腰围的增高而上升。通过不同BMI和腰围切点对于检出各项危险因素异常的敏感度和特异度分析，提出敏感度特异度较好、假阳性率较低的BMI切24为中国成人超重的界限，特异度达90％的BMI切点28为肥胖的界限；男性腰围≥85cm，女性≥80cm为腹部脂肪蓄积的界限。结论：切点以上的人群归因危险度百分比显示：将BMI控制到24以下，可能防止人群中45％－50％的危险因素聚集。对BMI在28及以上者药物控制到此点以下，可能防止15％－17％的危险因素聚集，从而降低心血管病和糖尿病的发病危险。男性腰围控制在85cm以下，女性腰围控制到80cm以下， 可能防止约47％－58％的解除因素聚集。根据以上分析结果，提出了对中国成人超重和肥胖界限的建议。     

《国民体质测定标准》中肥胖参数与高血压风险关系

目的评价《国民体质测定标准》中肥胖指标与正常偏高血压及高血压风险关系,并确定判定切点,为高血压的预防控制提供参考依据。方法采用分层整群抽样方法对在辽宁省沈阳、丹东、朝阳市3个国民体质监测点抽取的5 809名20～69岁未接受高血压药物治疗的居民进行体格检查。结果 5 809名居民的正常偏高血压率和高血压率分别为16.92%和24.89%,其中男性居民正常偏高血压率和高血压率分别为20.98%和31.57%,均高于女性居民的12.94%和18.33%,差异均有统计学意义(P<0.01);多因素logistic回归分析结果表明,年龄≥40岁和体质指数(BMI)是正常偏高血压的危险因素,女性是正常偏高血压的保护因素;年龄≥30岁、BMI和腰围是高血压的危险因素,女性是高血压的保护因素;控制年龄、性别的影响后,BMI每升高1个标准差,正常偏高血压和高血压的风险分别增大1.38倍(95%CI=1.28～1.50)和1.57倍(95%CI=1.39～1.78);腰围每升高1个标准差,高血压的风险增大1.37倍(95%CI=1.20～1.56);以约登指数最大确定切点,BMI判定正常偏高血压的切点为男性24.0 kg/m2、女性24.3 kg/m2,BMI判定高血压的切点为男性25.1 kg/m2、女性24.3 kg/m2,腰围判定高血压的切点为男性87.0 cm,女性80.6 cm;以灵敏度≥80%确定切点,BMI判定正常偏高血压的切点为男性23.0 kg/m2、女性22.3 kg/m2,BMI判定高血压的切点为男性23.4 kg/m2、女性22.8 kg/m2,腰围判定高血压的切点为男性82.0 cm、女性76.9 cm。结论高血压的风险随BMI及腰围的增加而增大,BMI与高血压的关联强度大于腰围。     

Predicting incident diabetes in Jamaica: the role of anthropometry

OBJECTIVE: To evaluate the performance of the body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) in predicting incident diabetes in Jamaica. RESEARCH METHODS AND PROCEDURES: A cohort of 728 nondiabetic adults (290 men and 438 women), ages 25 to 74 years and residents of Spanish Town, Jamaica, were followed for a mean of 4 years. Participants had fasting and 2-hour postchallenge glucose concentrations measured at baseline and follow-up. RESULTS: There were 51 cases of incident diabetes (17 men and 34 women). All indices were independent predictors of diabetes, and none was clearly superior. The area under the receiver operating characteristics curves (95% confidence interval) for BMI was 0.74 (0.59 to 0.88) for men and 0.62 (0.51 to 0.72) for women. For waist circumference, these values were 0.78 (0.65 to 0.91) in men and 0.61 (0.50 to 0.71) in women. Similar results were obtained for WHR and WHTR. "Optimal" cut-off points for BMI were 24.8 kg/m(2) (men) and 29.3 kg/m(2) (women). For waist circumference, these were 88 cm and 84.5 cm for men and women, respectively. Corresponding values for WHR were 0.87 and 0.80 and for WHTR were 0.51 and 0.54, respectively. DISCUSSION: Cut-off points for waist circumference and WHR were similar to those proposed in developed countries for women but lower in men. Waist circumference could be useful in health promotion as an alternative to BMI.     

Evaluation of waist circumference to predict general obesity and arterial hypertension in women in Greater Metropolitan Belo Horizonte,Brazil

This study examined the capacity of waist circumference (WC) to identify subjects with overweight (BMI >/=25) and obesity (BMI >/=30), in agreement with internationally recommended levels of action. Data were obtained from 791 women, 15-59 years old. After identifying overweight and obesity according to WC values, sensitivity and specificity were calculated to verify whether WC could be a good risk predictor for hypertension. Associations were tested by linear regression and logistic regression, controlling for confounding. WC cut-off points of 80cm and 88cm correctly identified 89.8% and 88.5% of women with overweight and obesity, respectively. Abdominal obesity (WC >/=88cm) was statistically associated with hypertension in the multivariate analysis (OR = 2.88; 95% CI: 1.77-4.67). Hypertension was identified with a sensitivity of 63.8% and 42.8%, and with a specificity of 68.0% and 83.3%, for WC >/=80 and >/=88, respectively. The proposed cut-off points for abdominal obesity can potentially distinguish individuals at risk for future obesity, but has only moderate power to predict individuals with high blood pressure.     

Measures of abdominal obesity within body mass index categories, 1981 and 2007-2009

This article describes measures of abdominal obesity--waist circumference, waist-to-hip ratio, and waist-to-height ratio--within body mass index (BMI) categories, using data from two population-based health surveys. Among normal-weight men, the percentages at increased/high health risk based on these three measures were not statistically different in 2007-2009 than in 1981. By contrast, among normal-weight women, increases were observed in the percentage at increased/high health risk based on each of the three measures. The percentage of overweight men at increased/high risk based on waist circumference rose from 49% in 1981 to 62% in 2007-2009, and among overweight women, the percentage at increased/high risk rose for each of the three measures (64% to 93% for waist circumference, 22% to 51% for waist-to-hip ratio, and 68% to 87% for waist-to-height ratio). Although substantial percentages of men and women in obese class I were at increased/high health risk based on abdominal obesity measures in 1981, by 2007-2009, almost everyone in this BMI category was at increased/high risk.     

Cut-off points for anthropometric indices of adiposity: differential classification in a large population of young women

Anthropometric indices of adiposity include BMI, waist circumference and waist:height ratio. In the recruitment phase of a prospective cohort study carried out between 1998 and 2002 we studied a population sample of 11 786 white Caucasian non-pregnant women in Southampton, UK aged 20-34 years, and explored the extent to which proposed cut-off points for the three indices identified the same or different women and how these indices related to adiposity. Height, weight and waist circumference were measured and fat mass was estimated from skinfold thicknesses; fat mass index was calculated as fat mass/height1.65. Of the subjects, 4869 (42 %) women were overweight (BMI > or = 25 kg/m2) and 1849 (16 %) were obese (BMI > or = 30 kg/m2). A total of 890 (8 %) subjects were not overweight but had a waist circumference > or = 80 cm and 748 (6 %) subjects were overweight but had a waist circumference < 80 cm (6 %). Of the women, 50 % had a BMI > or = 25 kg/m2 or a waist circumference > or = 80 cm or a waist:height ratio > or = 0.5. Of the variation in fat mass index, 85 % was explained by BMI, 76 % by waist circumference and 75 % by waist:height ratio. Our findings demonstrate that many women are differentially classified depending on which index of adiposity is used. As each index captures different aspects of size in terms of adiposity, there is the need to determine how the three indices relate to function and how they can be of use in defining risk of ill health in women.     

Appropriate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Chinese adults

BACKGROUND: Recent data suggest that current overweight and central adiposity guidelines based on Western populations are not appropriate for Asian populations. The published data among Chinese are insufficient to address this issue. OBJECTIVE: We aimed to identify cutoffs for body mass index (BMI; in kg/m(2)) and waist circumference that confer increased risk of cardiovascular disease in Chinese adults as would be consistent with overweight and central adiposity. DESIGN: A nationally representative, cross-sectional sample of 15 239 Chinese adults aged 35-74 y was studied. RESULTS: Mean blood pressure, total cholesterol, LDL-cholesterol, triacylglycerol, and glucose values were incrementally higher and mean HDL-cholesterol values were incrementally lower with each unit increase in BMI and waist circumference in both men and women. Both the point at which sensitivity equaled specificity and the shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or >/=2 of these risk factors suggested a BMI cutoff of 24 and a waist circumference cutoff of 80 cm for both men and women. CONCLUSIONS: Lower cutoffs for BMI and waist circumference are needed in the identification of Chinese patients at high risk of cardiovascular disease.     

中国成年人代谢异常相关的体质指数和腰围切点研究

目的 研究中国成年人BMI和腰围与各项代谢危险因素之间的相关性,确定超重肥胖的适宜BMI和腰围切点。方法 中国慢性病前瞻性研究于2004-2008年进行基线调查,并于2013-2014年随机抽取了5%的研究对象进行第2次重复调查。本研究剔除体格指标或代谢危险因素变量缺失或极端值、自报患有恶性肿瘤者,基线纳入501 201人,第2次重复调查纳入19 201人。比较不同BMI和腰围下代谢危险因素异常率,通过受试者工作特征（ROC）曲线分析,确定预测高血压、糖尿病、血脂异常和危险因素聚集的适宜BMI和腰围切点。结果 随BMI或腰围的增加,高血压、糖尿病、血脂异常和危险因素聚集患病率均呈现上升的趋势。依据正确指数最大的原则选取BMI超重切点和腰围切点,男性和女性BMI超重切点均接近24.0 kg/m²,男性腰围切点接近85 cm,女性腰围切点约为80~85 cm。男性和女性中,检出各项代谢危险因素特异度达到90%的BMI切点范围为27.0~28.9 kg/m²,多数接近28.0 kg/m²,以28.0 kg/m²作为肥胖切点。结论 本研究在更新开展的大样本调查中进一步验证了中国肥胖问题工作组2002年推荐的超重和肥胖标准,超重和肥胖的BMI切点分别为24.0和28.0 kg/m²;中心性肥胖的腰围适宜切点男性为85 cm,女性为80~85 cm。     

Body mass index and measures of adiposity among elderly adults

OBJECTIVE: To evaluate the nutritional status of elderly persons and to compare the correlation between the body mass index (BMI=kg/m2) with measures of adiposity and fat distribution among elderly and middle-aged adults. METHODS: Elderly persons (N=699; 60 years or older) and middle-aged adults (N=1,306; 40-59.9 years) participating in a population-based survey conducted in 1996 in the municipality of Rio de Janeiro were evaluated as to body mass index, arm, waist, and hip circumferences, skinfolds, and arm fat and muscle areas using standardized procedures. The cutoff points proposed by the World Health Organization for waist circumference, waist-to-hip ratio, and body mass index were used. Analyses were performed using the Spearman correlation coefficient and linear regression adjusted for age. RESULTS: About 50% of elderly subjects were classified as overweight and more than 50% of women in all age groups had waist circumference and waist-to-hip ratio outside the normal range. Among men, these percentages were about 40% for waist circumference and 20% for waist-to-hip ratio. Among elderly subjects, the partial correlation (adjusted for age) between body mass index and measures of adiposity (waist circumference, skinfolds, and arm fat area) ranged from 0.45 to 0.85 for men and 0.55 to 0.86 for women. Weight and waist circumference were the variables more strongly correlated with body mass index among both elderly persons and adults. CONCLUSIONS: The prevalence of overweight among elderly persons was high for both men and women. Body mass index shows a similar relationship with adiposity regardless of ageing.     

Relative importance of body mass index and waist circumference for hypertension in adults

OBJECTIVE: To assess the relative importance of Body Mass Index (BMI) and waist circumference for the determination of hypertension in adults. METHODS: Cross sectional analysis of a sample of employees (N=1,584), aged 18 to 64 years, from a private general hospital in the city of S?o Paulo, Brazil. Data collection included the application of a structured questionnaire and blood pressure, weight, high, and waist circumference measurements. Hypertension was defined as blood pressure levels >or= 140/90 mmHg or reported use of anti-hypertensive medication. The relative importance of BMI and waist circumference was evaluated by calculating the attributable fraction of hypertension corresponding to each anthropometric indicator, employing both the usual cut-off points as well as cut-off points based on the observed distribution of the indicator in the population. In addition, an indicator combining simultaneously BMI and abdominal circumference values was also developed. RESULTS: Prevalence of hypertension was 18.9% (26.9% in men and 12.5% in women). In men, the fraction of hypertension attributable to BMI exceeded the fraction attributable to waist circumference based on the usual cut-off points for the indicators (56% vs. 48%, respectively) and also considering the quartiles of the observed distribution for these indicators (73% vs. 69%, respectively). In women, the fraction of hypertension attributable to waist circumference was slightly higher than the fraction attributable to BMI based on the usual cut off points for both indicators (44% vs. 41%), but the reverse was true when quartiles of the observed distribution were used (41% vs. 57%, respectively). In women only, the fraction of hypertension attributable to the indicator combining BMI and waist circumference (64%) was higher that observed using each indicator alone. CONCLUSIONS: Both BMI and abdominal circumference were positively and independently associated with the occurrence of arterial hypertension, the influence of BMI being higher among men.     

Neck circumference as a simple screening measure for identifying overweight and obese patients

OBJECTIVE: There are numerous methods of assessing overweight and obesity. We undertook an observational study to test a method of identifying overweight or obese patients solely by measuring the circumference of the neck. RESEARCH METHODS AND PROCEDURES: A test sample and a second validation sample included 979 subjects (460 men and 519 women), who visited a family medicine clinic in a southern Israeli urban district for any reason between the randomly chosen months of January and September 1998. Main outcome included neck, waist, and hip circumferences; body mass index (BMI); and waist:hip ratio measures. RESULTS: Pearson's correlation coefficients indicated a significant association between neck circumference (NC) and: BMI (men, r = 0.83; women, r = 0.71; each, p < 0.0001), age (men, r = 0.33; women, r = 0.36; each, p < 0.0001), weight (men, r = 0.7; women, r = 0.81; each, p < 0.0001), waist circumference (men, r = 0.86; women, r = 0.85; each, p < 0.0001), hip circumference (men, r = 0.62; women, r = 0.56; each, p < 0.0001), and waist:hip ratio (men, r = 0.66; women, r = 0.87; each, p < 0.0001). NC > or=37 cm for men and > or =34 cm for women were the best cutoff levels for determining the subjects with BMI > or =25.0 kg/m(2) using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 98% sensitivity, 89% specificity, and 94% accuracy for men, and 100% sensitivity, 98% specificity, and 99% accuracy for women. NC > or =39.5 cm for men and > or =36.5 cm for women were the best cutoff levels for determining the subjects with BMI > or =30 kg/m(2) using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 93% sensitivity, 90% specificity, and 91% accuracy for men, and 93% sensitivity, 98% specificity, and 97% accuracy for women. DISCUSSION: NC measurement is a simple and time-saving screening measure that can be used to identify overweight and obese patients. Men with NC <37 cm and women with NC <34 cm are not to be considered overweight. Patients with NC > or =37 cm for men and > or =34 cm for women require additional evaluation of overweight or obesity status.     

Derivation of anthropometric cut-off levels to define CVD risk in Sri Lankan adults

Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative sample of 4474 non-institutionalised adults aged ≥?18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood samples were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors (P?相似文献   

Waist circumference, body mass index and health risk factors among middle aged Thais

Body mass index (BMI) and waist circumference (WC) are important contributors to major causes of health risk factors such as high blood cholesterol, high fasting blood sugar and high blood pressure. This analysis was designed to assess the associations between WC, BMI and each health risk factor in suitable cut-off points for WC and BMI among middle aged men and women of Thai population. Cross sectional data from the Second National Health Survey in Thailand was analysed. This set of data collected by the Ministry of Public Health from 1996 to 1997 was obtained from a total of 998 subjects (comprising 396 men and 602 women) aged 45-50. Results from the Receiver Operating Characteristic curve (ROC curve) identified those with health risk factors demonstrating cut-off points for WC between 81.5-84 centimeters for men and 76-80.5 centimeters for women and BMI between 23.3-23.9 kg/m2 for both genders, respectively. Results from the Multiple logistic regression analysis demonstrated lower risks of having high blood cholesterol, high fasting blood sugar and high blood pressure with cutoff points 84 cm for men, 80 cm for women and BMI 23 kg/m2 for both genders compared to cut-off points 102 cm for men, 88 cm for women and BMI 25 kg/m2 for both genders as specified for the population in Western countries. This study has proposed a waist circumference of 84 cm (33.6 inches) for middle aged Thai men and 80 cm (32 inches) for middle aged Thai women and BMI of 23 kg/m2 for both genders. Monitoring changes in the waist circumference over time along with BMI may be convenient and useful for middle aged Thais to prevent health risk conditions, even in the absence of a change in BMI.     

Effects of physical activity,body mass index,waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

The health benefits of physical activity (PA) have been well documented. However, there is less research investigating whether or not these health benefits might differ among males and females or among subjects characterized by different levels of body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Baseline total PA, BMI, WHR and waist circumference were measured in 14,585 men and 26,144 women who participated in the Swedish National March. Their effects on all-cause mortality were analyzed with a follow-up time of almost 10 years. Sedentary men with a BMI ≥ 30 had a 98% (95% CI: 30–201%) increased risk of mortality compared to normal weight men with a high level of total PA. The same trend was observed for sedentary men with high WHR or waist circumference, compared to lean and highly active men. Sedentary women with a waist circumference of 88 cm or more had almost doubled, i.e. 97% (95% CI: 35–189%) increased mortality risk compared to physically active women with a waist circumference below 80 cm. BMI in men, but waist circumference in women better forecast all-cause mortality. We found no substantial effect modification between different measures of adiposity and physical activity—physical inactivity and obesity seem to increase total mortality risk independently and additively.     

左旋肉碱类膳食补充对超重肥胖成年人体格指标的影响

目的 评价左旋肉碱类膳食补充对超重肥胖成年人减重干预的有效性。方法 招募北京居住一年以上20～50岁符合标准的志愿者120名,采用随机对照研究设计,将受试者随机分组,干预组60名,对照组60名。给予干预组左旋肉碱类膳食补充,同时两组均给予健康生活宣传材料,干预期为6个月。对受试者进行基线和终期2次常规体检,包括身高、体重、腰围、臀围和体脂率。结果 干预6个月后,干预组60名研究对象的体重、腰围、臀围、体质指数(Body mass index,BMI)、腰臀比和体脂率相较于对照组有明显改善,干预组体重下降2.76(SD:1.81)kg,腰围下降4.46(SD:4.34)cm,臀围下降3.48(SD:2.65)cm,BMI下降0.99(SD:0.68)kg/m²,腰臀比下降0.01(SD:0.04),体脂率下降0.97(SD:2.00)%,干预组和对照组上述指标差异具有统计学意义(体重差值t=6.277, P<0.001; 腰围差值t=5.010, P<0.001; 臀围差值t=4.452, P<0.001; 体质指数差值t=6.264, P<0.001; 腰臀比差值t=2.347, P<0.05; 体脂率差值t=2.873, P<0.05); 不同性别之间腰臀比和体脂率变化具有差异。结论 左旋肉碱类膳食补充配合运动与健康宣教能够有效降低超重肥胖人群BMI、腰臀比和体脂率水平,为超重肥胖人群减重方法的选择提供参考。     

Identifying obesity indicators which best correlate with type 2 diabetes in a Chinese population

ABSTRACT: BACKGROUND: Obesity has been shown to be a prognostic indicator of type 2 diabetes (T2D); however, the power of different obesity indicators in the detection of T2D remains controversial. This study evaluates the detecting power of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR) for the presence of T2D in undiagnosed diabetics among the Chinese population. METHODS: Individuals were selected from an ongoing large-scale population-based Beijing Community Pre-Diabetes (BCPD) study cohort. The oral glucose tolerance tests (OGTT) were performed to diagnose diabetes. A total of 220 new cases of T2D and 1,868 normal blood glucose subjects were analyzed. ROC curve analyses were used to compare the association of different obesity indicators with T2D and determine the optimal cut-off points of the best predictor for identifying T2D in men and women. RESULTS: All indicators positively correlated with presence of T2D in both men and women. In women, WC, WHR and WHTR were similar, but were better in identifying T2D when compared to BMI (P < 0.0001, P=0.0016 and P=0.0001, respectively). In men, WC, WHTR and BMI were similar, but WC and WHTR were better than WHR (P=0.0234, P=0.0101, respectively). For women, 86 cm was the optimal WC cut-off point, and its sensitivity and specificity were 0.714 and 0.616; for men, the optimal cut-off point was 90 cm, and its sensitivity and specificity were 0.722 and 0.571. CONCLUSION: Compared with BMI, WHR and WHTR, WC is a simple and accurate measure for predicting T2D in the Chinese population.     

Prevalence of overweight and obesity in elderly people in Spain

OBJECTIVE: To estimate the prevalence of obesity and overweight in the older adult population in Spain by sex, age, and educational level. RESEARCH METHODS AND PROCEDURES: A cross-sectional study was carried out in 2001 in a sample of 4009 persons representative of the noninstitutionalized population > or = 60 years of age. Anthropometric measurements (BMI and waist circumference) were obtained using standardized techniques and equipment. Overweight was considered at a BMI of 25 to 29.9 kg/m2 and obesity at a BMI of > or = 30 kg/m2. Central obesity was considered at a waist circumference of >102 cm in men and >88 cm in women. RESULTS: The mean BMI was 28.2 kg/m2 in men and 29.3 kg/m2 in women. The prevalence of overweight and obesity in men was 49% and 31.5%, respectively. The corresponding percentages in women were 39.8% and 40.8%. The prevalence of obesity was higher in persons with no education than in those with third level education (i.e., university studies), especially among women (41.8% vs. 17.5%). The prevalence of central obesity was 48.4% in men and 78.4% in women. Differences by educational level were seen in only women, in whom the prevalence of central obesity was 80.9% in those with no education and 59% in those with third-level education. DISCUSSION: The prevalence of overweight and obesity in the Spanish adult elderly population is very high. Some other populations show similar prevalences, especially in Mediterranean countries. Socioeconomic conditions in Spain during the years these cohorts were born may partly explain the high-frequency of obesity.     

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.     

Evaluation of waist circumference to predict cardiova scular risk factors in an overweight Tehranian population: findings from Tehran Lipid and Glucose Study

This study was conducted to evaluate the waist circumference (WC) cut-off points to predict cardiovascular risk factors in the overweight Tehranian population. Anthropometric measures, blood pressure, and biochemical analyses were evaluated for the 15,005 participants of the Tehran Lipid and Glucose Study. Three thousand sixty-five subjects aged 18-74 years with a body mass index of 25-29.9 were enrolled in this study. Abdominal obesity was defined as WC > or =102 cm for men and > or =88 cm for women. Sensitivity of WC > or =102 cm to detect various cardiovascular risk factors for men aged 35-54 years was between 5% and 14%, and for men aged 55-74 years, was between 12% and 19%. The specificity of this cut-off point was between 93% and 98% and between 86% and 96% for corresponding age-categories, respectively. WC > or =88 cm had a sensitivity of between 28% and 41 % for identifying cardiovascular risk factors in women aged 18-34 years. Sensitivity tended to increase with age and specificity tended to decrease with age in both genders. These cut-off points had the highest positive predictive value for the more prevalent risk factors in both genders. The negative predictive values were different for various risk factors among age groups. The classic cut-off points of WC failed to provide adequate evidence for the use of WC in detecting cardiovascular risk factors. Further studies should be conducted to determine optimal WC cut-off points for Iranians.     

Self-reported and technician-measured waist circumferences differ in middle-aged men and women

We investigated the agreement between 1) self-reported and technician-measured waist circumference at the level of the umbilicus, 2) circumference measured at the level of the umbilicus and halfway between the lower rib and the iliac crest (the natural waist), and 3) self-reported circumference at the level of the umbilicus and technician-measured circumference at the natural waist. At follow-up in the Danish "Diet, Cancer and Health" study, we recruited 176 men and 240 women for a validation study. Bland-Altman plots were used to evaluate agreement among measurement sites. Multiple regression was used to identify variables explaining the difference between measurements. The participants underestimated their waist circumference; the mean differences were -1.6 cm (95% CI: -2.4 cm, -0.8 cm) in men and -3.0 cm (95% CI: -3.8 cm, -2.3 cm) in women. Limits of agreement were from -11.9 to +8.7 cm among men and -14.9 to +8.9 cm among women. High BMI and large baseline waist circumference were associated with a larger degree of underreporting. Waist circumference measured at the level of the umbilicus was larger than at the natural waist; the mean differences were +0.7 cm (95% CI: +0.4 cm, +1.1 cm) in men and +5.0 cm (95% CI: +4.4 cm, +5.6 cm) in women. The self-reported waist circumference at the level of the umbilicus was correlated with the technician-measured circumference at the natural waist. The circumference at the natural waist was overestimated for women, depending on baseline waist circumference, and slightly underestimated for men, depending on baseline BMI.