Abstract
BackgroundCurrent criterion of waist circumference (WC) for abdominal obesity is not enough to demonstrate characteristics of obese and non-obese populations defined by BMI. The aim of this study was to redefine the cutoff values of WC according to general obesity (BMI ≥ 25 kg/m2).MethodsThe receiver operating characteristic curve analysis was performed to determine cutoff values of WC for predicting atherosclerosis according to BMI in 1,063 non-diabetic subjects. To validate this new criterion, diabetic patients (n = 3,690) were divided into three groups based on the current (WC of 90/80 cm for men/women) and new cutoff values of WC: 1) group with WC below the lowest value of two criteria; 2) intermediate group defined as having a WC between them; and 3) group with WC more than the highest value of them.ResultsThe new cutoff values of WC for predicting atherosclerosis in non-diabetic subjects were 84/76 cm for non-obese men/women, and 93/87 cm for obese men/women, respectively. Of non-obese diabetic patients, the intermediate group (WC 84 ~ 90/76 ~ 80 cm for men/women) was more insulin resistant and showed elevated odds ratio (OR) for having 2 or more metabolic risk factors compared to group with WC below 84/76 cm for men/women [OR 2.48 (95 % CI 1.89–3.25) in men, 2.01 (95% CI 1.45–2.78) in women]. In contrast, among obese diabetic patients, insulin resistance and the likelihood of having 2 or more metabolic risk factors were not different from the intermediate group (WC 90 ~ 93/80 ~ 87 cm for men/women) and group with WC below 90/80 cm for men/women.ConclusionsThe current universal cutoff values of WC may under- or over-estimate the metabolic risks of intermediate groups. Therefore, the WC criteria for abdominal obesity should be applied differently depending on the BMI.Electronic supplementary materialThe online version of this article (doi:10.1186/s12986-016-0085-y) contains supplementary material, which is available to authorized users.
Highlights
Current criterion of waist circumference (WC) for abdominal obesity is not enough to demonstrate characteristics of obese and non-obese populations defined by BMI
The new cutoff was chosen by maximizing the sums of the Youden’s index where—1. To validate these new criteria, diabetic patients were divided into three groups based on the current (WC of 90/80 cm for men/women) and new cutoff values of WC according to gender and general obesity: 1) group with WC below the lowest value of two criteria; 2) intermediate group defined as having a WC between them; and 3)
The optimal WC measurements as obtained from receiver operating characteristic (ROC) curves were used for predicting atherosclerosis in non-diabetic subjects were 84 cm in non-obese men, 76 cm in non-obese women, 93 cm in obese men, and 87 cm in obese women, respectively
Summary
Current criterion of waist circumference (WC) for abdominal obesity is not enough to demonstrate characteristics of obese and non-obese populations defined by BMI. The aim of this study was to redefine the cutoff values of WC according to general obesity (BMI ≥ 25 kg/m2). Obesity is known as a potent risk factor for metabolic disorder and cardiovascular disease [1]. Increasing evidence has shown that abdominal obesity is critical risk factor for the development of insulin resistance, metabolic syndrome, type 2 diabetes, and cardiovascular disease [4,5,6,7]. Not all non-obese individuals present with a healthy metabolic profile [12]. Such discrepancies between obesity and metabolic abnormalities have been explained by several factors, including fat distribution [13]. It is necessary to separately define the precise criteria for abdominal obesity by
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