Whether Waist Circumference Research Articles

Usefulness of New Criteria for Metabolic Syndrome Optimized for Prediction of Cardiovascular Diseases in Japanese.

We attempted to clarify whether the multiple criteria for metabolic syndrome (MetS) can sufficiently predict cardiovascular disease, whether waist circumference (WC) should be required, and whether sex-specific thresholds for each component are necessary. Only a few large-scale studies among East Asians have addressed the ability of MetS to predict cardiovascular disease. We analyzed the data of 330,051 men and 235,028 women aged 18-74 years with no history of coronary artery disease (CAD) or cerebrovascular disease (CVD) from a nationwide Japanese claims database accumulated during 2008-2016. The association of each MetS component with CAD or CVD (CAD/CVD), MetS associated with CAD/CVD according to various criteria, and utility of modified criteria with more specific optimal values for each component were examined using multivariate Cox regression and receiver operating characteristic (ROC) analysis. During the study, 3,934 men (1.19%) and 893 women (0.38%) developed CAD/CVD. For each current MetS criteria, there was a 1.3- to 2.9-fold increased risk of CAD/CVD. Optimal thresholds for predicting CAD/CVD were WCs of 83 and 77 cm, triglycerides levels of 130 and 90 mg/dl, high-density lipoprotein cholesterol levels of 50 and 65 mg/dl, blood pressures of 130/80 and 120/80 mmHg, and fasting plasma glucose levels of 100 and 90 mg/dl for men and women, respectively. The existing MetS criteria and modified criteria were not significantly different in predicting CAD/CVD, but using the modified criteria markedly increased the prevalence of MetS and percentage of people with MetS developing CAD/CVD. Although various criteria for MetS similarly predicted CAD/CVD, the new criteria greatly reduced the number of high-risk individuals, especially women, overlooked by the current criteria.

Combination of Waist Circumference and Circulating Levels of IGFBP-2 as a Simple Screening Tool for Early Detection of Metabolic Dysfunction-Associated Steatotic Liver Disease.

Optimal non-invasive biomarkers for metabolic dysfunction-associated steatotic liver disease (MASLD) remain elusive, especially in the detection of early stages. This study tested in an asymptomatic cohort of 171 men (49.2 ± 8.6 years) and 131 women (51.8 ± 8.5 years) whether waist circumference (WC) and circulating levels of insulin-like growth factor-binding protein 2 (IGFBP-2) could identify individuals with liver fat >5% as assessed by magnetic resonance spectroscopy. Participants with high WC (> 85 or 90 cm for women and men, respectively) and low IGFBP-2 (< 260 or 230 ng/mL for women and men, respectively) were characterized by a higher risk of having MASLD (46.3%, p < 0.0001). Among the 68 individuals with MASLD, 73.5% fell into the subgroup with high WC and low IGFBP-2 concentrations (p < 0.0001). When combined, these markers reached a sensitivity of 73.5% and specificity of 75.2% for MASLD. Thus, WC and plasma IGFBP-2 levels might be useful as a novel, simple, and non-invasive index to support existing tools in the identification of individuals at risk of early-stage MASLD.

Comparison of the Ability of Anthropometric Indices to Predict the Risk of Diabetes Mellitus in South African Males: SANHANES-1.

This study aimed to assess the sensitivity of body mass index (BMI) to predict the risk of diabetes mellitus (DM) and whether waist circumference (WC), waist-to-hip (WHR) and waist-to-height (WHtR) ratios are better predictors of the risk of DM than BMI in South African men aged 20 years and older. Data from the first South African National Health and Nutrition Examination Survey (SANHANES-1) were used. Overall, 1405 men who had valid HbA1c outcomes were included. The sensitivity, specificity, and optimal cut-off points for predicting DM were determined using the receiver operating characteristic (ROC) curve analysis. A total of 34.6% percent of the study participants were overweight/obese, while 10.5%, 10.4%, 36.6% and 61.0% had HbA1c, WC, WHR and WHtR above the normal reference ranges, respectively. Based on age-adjusted logistic regression analysis, the highest likelihood of DM was observed for those participants who had increased WC and WHtR (odds ratios [OR] were 6.285 (95% CI: 4.136–9.550; p < 0.001) and 8.108 (95% CI: 3.721–17.667; p < 0.001)). The ROC curve analyses for WC, WHR, and WHtR displayed excellent ability to predict the risk of DM, with their areas under the curve (AUC) being 80.4%, 80.2% and 80.8%, respectively. The overall cut-off points to predict the risk of DM for WC, WHR, and WHtR were ≥88.95 cm, ≥0.92, and >0.54, respectively. The ROC analysis for BMI, on the other hand, showed acceptable ability to predict the risk of DM (AUC = 75.6%), with its cut-off point being ≥24.64 kg/m2. Even after stratifying the data by two age groups, WHtR remained a superior index to predict DM, especially in the younger age group. To conclude, no significant differences were observed between the AUC for BMI the AUCs for other indices. However, the AUCs for these indices showed significant excellent ability as opposed to the significant acceptable ability of BMI to predict DM in adult South African men.

Abstract 11145: Waist Circumference is a Predicter of All-Cause Death in General Population in Wanshou Lu

Introduction: The accumulation of abdominal fat increases risk of metabolic disorders and premature death. Whether waist circumference (WC), a surrogate marker for abdominal adiposity can predict all-cause death in general population is still inconclusive. Hypothesis: We assessed the hypothesis that higher level of WC is significantly associated with long-term all-cause death in general population. Methods: In this prospective cohort study, a total of 1521 consecutive subjects were included. The subjects. The end point was all-cause death. The association between Waist circumference and outcomes was investigated using multivariable COX regression. Results: During a median follow up of 9.1 years, there were 265 patients died. Kaplan-Meier survival estimates indicated that the patients with higher levels of waist circumference (WC&gt; 94cm) had a significantly increased risk of all-cause death (log-rank p&lt;0.001). After adjustment for potential confounders, multiple COX regression models showed that higher level of WC was an independent predictor in developing all-cause death (HR 3.02; 95% CI: 1.88-4.83; p&lt;0.001). We saw a significant increase of AUC in ROC curve after addition of WC to a clinical model, the increase of AUC is (0.586 vs 0.619) for long-term all-cause death (p&lt;0.001). Furthermore, WC significantly improved the net reclassification index (0.629; P=0.001), and integrated discrimination index (0.035; P=0.002). Conclusion: In conclusion, higher level of WC is significantly associated with long-term all-cause death. WC may provide incremental prognostic value beyond traditional risks factors. Key words: Waist circumference, obesity, all-cause death

Body mass index and waist circumference in relation to the risk of 26 types of cancer: a prospective cohort study of 3.5 million adults in Spain

BackgroundA high body mass index (BMI) has been associated with increased risk of several cancers; however, whether BMI is related to a larger number of cancers than currently recognized is unclear. Moreover, whether waist circumference (WC) is more strongly associated with specific cancers than BMI is not well established. We aimed to investigate the associations between BMI and 26 cancers accounting for non-linearity and residual confounding by smoking status as well as to compare cancer risk estimates between BMI and WC.MethodsProspective cohort study with population-based electronic health records from Catalonia, Spain. We included 3,658,417 adults aged ≥ 18 years and free of cancer at baseline between 2006 and 2017. Our main outcome measures were cause-specific hazard ratios (HRs) with 99% confidence intervals (CIs) for incident cancer at 26 anatomical sites.ResultsAfter a median follow-up time of 8.3 years, 202,837 participants were diagnosed with cancer. A higher BMI was positively associated with risk of nine cancers (corpus uteri, kidney, gallbladder, thyroid, colorectal, breast post-menopausal, multiple myeloma, leukemia, non-Hodgkin lymphoma) and was positively associated with three additional cancers among never smokers (head and neck, brain and central nervous system, Hodgkin lymphoma). The respective HRs (per 5 kg/m2 increment) ranged from 1.04 (99%CI 1.01 to 1.08) for non-Hodgkin lymphoma to 1.49 (1.45 to 1.53) for corpus uteri cancer. While BMI was negatively associated to five cancer types in the linear analyses of the overall population, accounting for non-linearity revealed that BMI was associated to prostate cancer in a U-shaped manner and to head and neck, esophagus, larynx, and trachea, bronchus and lung cancers in an L-shaped fashion, suggesting that low BMIs are an approximation of heavy smoking. Of the 291,305 participants with a WC measurement, 27,837 were diagnosed with cancer. The 99%CIs of the BMI and WC point estimates (per 1 standard deviation increment) overlapped for all cancers.ConclusionsIn this large Southern European study, a higher BMI was associated with increased risk of twelve cancers, including four hematological and head and neck (only among never smokers) cancers. Furthermore, BMI and WC showed comparable estimates of cancer risk associated with adiposity.

Abdominal Obesity is More Predictive of Advanced Colorectal Neoplasia Risk Than Overall Obesity in Men

We aimed to ascertain whether waist circumference (WC) is associated with risk of colorectal neoplasia (CRN), independent of body mass index (BMI). Although several studies have reported the association between abdominal obesity, measured by WC, and CRN, it remains unclear whether their association is biased by BMI. A cross-sectional study was performed on 154,552 asymptomatic examinees who underwent colonoscopy for a health check-up. The mean age was 42.6 years, and the proportion of males was 65.2%. The prevalence rate of CRN in subjects in WC quartiles 1, 2, 3, and 4 was 15.6%, 18.1%, 20.4%, and 22.0% among men and 7.8%, 9.4%, 12.2%, and 15.8% among women, respectively. WC and BMI were independent risk factors for overall CRN and nonadvanced CRN in both men and women. In men, the association of BMI with advanced CRN was attenuated to null after adjusting for WC [Q2, Q3, and Q4 vs. Q1; odds ratios (95% confidence intervals), 0.93 (0.79-1.10), 0.85 (0.71-1.03), and 0.99 (0.80-1.22), respectively; Ptrend=0.822], whereas the association of WC with advanced CRN significantly persisted even after adjusting for BMI [Q2, Q3, and Q4 vs. Q1; 1.20 (1.02-1.42), 1.45 (1.20-1.75), and 1.64 (1.32-2.04), respectively; Ptrend<0.001]. In women, neither WC nor BMI was associated with the risk of advanced CRN. Abdominal obesity is associated with an increased risk of advanced CRN, independent of overall obesity (BMI) in men. Our findings suggest that abdominal obesity is more strongly predictive of advanced CRN than overall obesity in men.

Waist circumference is associated with liver fat in black and white adolescents.

We examined whether waist circumference (WC) is associated with liver fat in black and white adolescents. Liver fat was measured using a 3T proton magnetic resonance spectroscopy (1H-MRS) in 152 overweight/obese adolescents (94 black and 58 white, body mass index (BMI) ≥85th percentile, aged 12-18 years) without liver diseases or diabetes. WC was measured at the last rib. Total and visceral adipose tissue (VAT) were measured by dual-energy X-ray absorptiometry and magnetic resonance imaging, respectively. The proportion of fatty liver (defined as liver fat ≥5.0% by 1H-MRS) was lower (P < 0.01) in black adolescents (5.3%) compared with their white peers (24.1%). Despite similar age, BMI, WC, and total adiposity (%), black adolescents had lower (P < 0.01) VAT (59.0% vs. 81.3 cm2), liver fat (1.6% vs. 3.5%), and alanine aminotransferase (17.2 vs. 22.0 IU/L) compared with their white peers. Independent of race, WC was associated with liver fat (black, r = 0.43; white, r = 0.64) in a similar magnitude to the association between VAT and liver fat (black, r = 0.44; white, r = 0.51) and these findings remained significant after controlling for age, sex, Tanner stage, and total adiposity. In blacks, WC and sex (male) were independent (P < 0.01) predictors of liver fat, explaining 17.1% and 5.6% of the variance, respectively, while in whites WC was the single best predictor, explaining 40.8% of the variance in liver fat. These findings suggest that enlarged WC is a marker of increased liver fat in overweight/obese white and black adolescents.

Relação entre Circunferência da Cintura e Pressão Arterial em Adolescentes

O objetivo do presente estudo é verificar se medidas de Circunferência da Cintura (CC) se relacionam com valores de Pressão Arterial (PA) alterada, em adolescentes. A amostra foi composta por 93 indivíduos (47 masculino e 46 feminino), com idade média = 11,17 anos. Foi aferida a PA, assim como a medida de CC, peso e altura, e os alunos responderam um questionário de caracterização da amostra. A prevalência de CC alterada foi de 53,76%, e de hipertensos foi de 7,53%. O coeficiente de correlação de Pearson foi de r = 0,473 para PAS e CC, e r = 0,419 para PAD e CC, ambos com p = 0,021 (p &lt; 0,05). Os achados demonstram uma correlação fraca (0 &lt; r &lt; 0,50), positiva e significativa (p &lt; 0,05) entre PAS, PAD e CC, indicando que adolescentes que apresentaram PAS e PAD com valores acima dos valores de referência também apresentaram medidas de CC elevadas.

Changes in abdominal fat following antiretroviral therapy initiation in HIV-infected individuals correlate with waist circumference and self-reported changes.

We examined whether waist circumference (WC) and self-reported abdominal size changes can estimate visceral adipose tissue (VAT) changes for those initiating antiretroviral therapy (ART). Prospectively collected data from ACTG A5257 and its metabolic substudy, A5260s, were used for this analysis. ART-naive HIV-infected participants were randomized to one of three contemporary ART regimens. Changes in abdominal CT-measured VAT and total adipose tissue (TAT) and DXA-measured trunk fat were tested for association with WC changes (by Pearson correlation) and categories of self-reported abdominal size changes (by ANOVA) between entry and week 96. Linear models compared WC and self-reported changes. The study population (n=328) was predominantly male (90%) and White non-Hispanic (44%) with a baseline median age of 36 years and body mass index of 25 kg/m2. At week 96, median WC change was +2.8 cm. Of those reporting at week 96, 53% indicated 'no change/lost', 39% 'gained some/somewhat larger' and 8% 'gained a lot/much larger' as their self-reported changes. Trunk fat, VAT and TAT changes differed across self-reported groups (ANOVA P<0.0001 for all), and the group ordering was as expected. WC changes were strongly correlated with CT and DXA changes (trunk fat: ρ=0.72, p<0.0001; VAT: ρ=0.52, p<0.0001; TAT: ρ=0.62, p<0.0001). While WC changes explained a greater proportion of VAT, TAT and trunk fat variation, self-reported changes remained a significant predictor after controlling for WC (p<0.05). WC and self-reported abdominal changes each correlated directly with imaging-derived abdominal fat measures, and can be used as reliable, affordable tools for central adiposity assessment.

Is White rice the culprit for the expanding waist line in South Indians?

Increasing prevalence of overweight and obesity in India has a direct association with the rising prevalence of obesity-related co-morbidities. Dietary factors are correlated with overweight and obesity; therefore, dietary intervention could be a target for obesity prevention. Objective: To assess the nutritional status of the diabetic population and to evaluate if white rice is contributing to the high prevalence of abdominal obesity, general obesity in the study group. Whether Waist Circumference (WC) and Waist Hip Ratio(WHR) are better indices for measuring obesity than Body mass Index(BMI) Methods: An observational study was done in a total of 23417 diabetics (9183 women, 14234 men) between the age group of 25-98 years. Body weight, height, waist and hip circumference were measured and recorded using standard measuring instruments. Classification of obesity was done using World Health Organisation (WHO) and International Diabetes Federation (IDF) criteria for BMI in Asians, while WC and WHR according to IDF criteria. Nutritional status of 3750 patients was assessed based on 24 hour dietary recall, accounting for the amount of carbohydrates, proteins and fat intake. Also the number of servings of vegetables and fruits were recorded. Results: Prevalence of overweight and obese according to BMI (WHO) is 85% in women and 74% in men. WHR identified 89% of men with abdominal obesity compared to 76% of women. The waist circumference among men and women according to the IDF criteria 65% men (n=9235) and 89 % women (n=8175) have a WC above the normal. This proves that WHR and WC are better indices than BMI in identifying people with abdominal obesity and high risk for cardiovascular morbidity. The age incidence of diabetes was similar in both men and women. Major calories are derived from carbohydrates up to the extent of 80% of which 50% is derived from white rice thus contributing to the higher prevalence of both abdominal and general obesity. In people with abnormal WC they were consuming 300-400 calories derived from white rice. The high caloric white rice adds to the burden of abdominal obesity and general obesity. 52 % were consuming higher than 2000k calories of their daily intake. The protein consumption is only 8.5% of the total calories and this clearly indicates that there is protein deficiency in the population. 63% consumed less than 2 servings of vegetables against the recommended 3-4 servings. And 66% did not consume any fruits at all. The mean protein intake in the population is 8.53% against the recommended 20-30%. Conclusion: High intake of carbohydrate rich diet, with major contribution from the white rice, low fibre, and low protein, inadequate intake of fruits and vegetables, lack of adequate physical activity is contributing to very high prevalence of abdominal obesity and general obesity. WC and WHR are better indices in defining obesity in the population. We need to change the practice of consumption of white rice to a healthy option of unpolished rice or brown rice, with whole grains and adequate fruits and vegetables.

Is waist circumference per body mass index rising differentially across the United States, England, China and Mexico?

Little is known about whether waist circumference (WC) has increased disproportionately relative to body mass index (BMI) around the world. Data came from the US National Health and Nutrition Examination Survey (1988-1994 and 2007-2010), Health Survey for England (1992-1993 and 2008-2009); the Mexican Nutrition Survey (1999) and the Mexican National Health and Nutrition Survey (NHNS 2012); and the China Health and Nutrition Survey (1993 and 2011). Country- and sex-stratified (for the United States, also race-/ethnicity-stratified) multivariable linear regressions were used to estimate mean difference in WC over time relative to BMI at specified overweight and obesity cutoff points, adjusting for age and survey year. Although mean WC and BMI shifted upward over time in all age-sex subpopulations in all four countries, trends in overweight prevalence were less consistent. However, WC relative to BMI increased at varying magnitudes across all countries and subpopulations, except US Black men. The magnitude of increase was largest for women in the youngest age group (20-29 years), particularly for women in Mexico (+6.6 cm, P<0.0001) and China (+4.6 cm, P<0.0001) (holding BMI constant at 25 kg/m(2)). For men, the increase was primarily evident among Chinese men (+4.8 cm, P<0.0001). WC has increased disproportionately over time relative to overall body mass across the United States, England, Mexico and China, particularly among young women, with the largest increases occurring in the middle-income countries of Mexico and China. These patterns are potentially a cause for concern especially for countries undergoing rapid economic and nutritional transitions.

Usefulness of Measuring Both Body Mass Index and Waist Circumference for the Estimation of Visceral Adiposity and Related Cardiometabolic Risk Profile (from the INSPIRE ME IAA Study)

Despite its well-documented relation with visceral adiposity (VAT) and cardiometabolic risk (CMR), whether waist circumference (WC) should be measured in addition to body mass index (BMI) remains debated. This study tested the relevance of adding WC to BMI for the estimation of VAT and CMR. In the International Study of Prediction of Intra-abdominal Adiposity and Its Relationship with Cardiometabolic Risk/Intra-abdominal Adiposity, 297 physicians recruited 4,504 patients (29 countries). Both BMI and WC were measured, whereas VAT and liver fat were assessed by computed tomography. A composite CMR score was calculated. From the 4,109 patients included in the present analyses (20 ≤ BMI < 40 kg/m(2), 47% women), about 30% displayed discordant values for WC and BMI quintiles, despite a strong correlation between the 2 anthropometric variables (r = 0.87 and r = 0.84 for men and women, respectively, p <0.001). Within each single BMI unit, VAT and WC showed substantial variability between subjects (mean difference between 90th and 10th percentiles: 175 cm(2)/16 cm and 137 cm(2)/18 cm for VAT/WC in men and women, respectively). Within each BMI category, increasing gender-specific WC tertiles were associated with significantly higher VAT, liver fat, and with a more adverse CMR profile. In conclusion, this large international cardiometabolic study highlights the frequent discordance between BMI and WC, driven by the substantial variability in VAT for a given BMI. Within each BMI category, WC was cross-sectionally associated with VAT, liver fat, and CMR factors. Thus, WC allows a further refinement of the CMR related to any given BMI.

Central adiposity after breast cancer diagnosis is related to mortality in the Health, Eating, Activity, and Lifestyle study.

We examined whether waist circumference (WC) and waist-to-hip ratio (WHR) after breast cancer diagnosis are associated with all-cause or breast cancer-specific mortality and explored potential biological pathways mediating these relationships. Our analysis included 621 women diagnosed with local or regional breast cancer who participated in the Health, Eating, Activity, and Lifestyle study. At 30 (±4) months postdiagnosis, trained staff measured participants' waist and hip circumferences and obtained fasting serum samples for biomarker assays for assays of insulin, glucose, C-peptide, insulin growth factor-1 and binding protein-3, C-reactive protein (CRP), and adiponectin. We estimated multivariate hazard ratios (HR) and 95% confidence intervals (CI) for death over ~9.5years of follow-up. After adjustment for measured body mass index, treatment, comorbidities, race/ethnicity, diet quality, and postdiagnosis physical activity, WC was positively associated with all-cause mortality (HRq4:q1: 2.99, 95% CI 1.14, 7.86) but its positive association with breast cancer-specific mortality was not statistically significant (HRq4:q1: 2.69, 95% CI 0.69, 12.01). WHR was positively associated with all-cause mortality (HRq4:q1: 2.10, 95% CI 1.08, 4.05) and breast cancer-specific mortality (HRq4:q1: 4.02, 95% CI 1.31, 12.31). After adjustment for homeostatic model assessment (HOMA) score and C-reactive protein, risk estimates were attenuated and not statistically significant. In this diverse breast cancer survivor cohort, postdiagnosis WC and WHR were associated with all-cause mortality. Insulin resistance and inflammation may mediate the effects of central adiposity on mortality among breast cancer patients.

Waist circumference and insulin resistance in elderly men: an analysis of Kahrizak elderly study

BackgroundDiagnosis of the metabolic syndrome (MS) is crucial for health care practitioners to identify at risk people for early treatment. Visceral obesity may make unnecessary other laborious measures of insulin resistance. The aim of this study was to see whether waist circumference (WC) can predict insulin resistance as well as MS in a group of Iranian elderly.MethodsOut of 94 nondiabetic elderly, thirty three subjects were recognized with MS. MS diagnosis was based on NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) and IDF (International Diabetes Federation) definitions. HOMA (Homeostasis Model Assessment) index was used to measure insulin sensitivity. Insulin resistance (IR) was defined as top quartile of HOMA.ResultsIn both sexes, WC and HOMA index were significantly positively correlated. The optimal waist circumference (OWC) cutoff point was 94.5 cm for men and 90.5 cm for women. The high sensitivity (0.80) and specificity (0.84) of WC in males indicates the proportion of IR which is correctly identified and recognizes all non-IR males as such. In regression model only the TG level was associated with WC. But the WC is strongly associated with HOMA-IR.ConclusionsWhile OWC is very likely a good measure to exclude non-IR subjects in our study, determination of optimal WC to identify elderly IR subjects warrants further study in a larger sample of the general population.

Correlation between Waist Circumference and Carotid Intima-Media Thickness in Women from Shanghai, China

ObjectiveTo evaluate whether waist circumference (WC) ≥85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China. MethodsA total of 2365 females aged ≥20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness (C-IMT) was measured. ResultsThe C-IMT was significantly higher in overweight or obese women with their BMI ≥25.0 kg/m2 (P<0.01) and in those with their WC ≥85 cm than in those with their WC <85 cm (P<0.01). Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC < 85 cm (P<0.01) while no significant tendency was found in the subgroup with its WC≥85 cm (P=0.07). Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC ≥80 cm, ≥80 cm and <85 cm and ≥85 cm for evaluating the risk of C-IMT elevation was 1.632, 1.501, and 1.878, respectively. ConclusionWC is significantly correlated with C-IMT in women from Shanghai, China, and WC≥85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.

Waist Circumference as a Predictor of Adiponectin Levels in Peritoneal Dialysis Patients: A 12-Month Follow-up Study

This prospective study, conducted at the dialysis unit of the Nephrology Division, Federal University of Sao Paulo-Oswaldo Ramos Foundation, Brazil, aimed to evaluate whether waist circumference (WC) can predict adiponectin levels in patients undergoing peritoneal dialysis (PD). Among 115 patients on PD at a single dialysis center who were evaluated at 6 and 12 months, 57% were men, 31% had diabetes, mean age was 52.8 ± 16.1 years, body mass index was 25 ± 4.3 kg/m(2), and dialysis vintage was 13 months (range: 5 - 33 months). We measured WC at the umbilicus level. Adiponectin was determined by an enzyme-linked immunosorbent assay. At baseline, WC was inversely associated with adiponectin (r = -0.48, p < 0.01). After adjustment for sex, age, diabetes, peritoneal clearance, and residual renal function, WC was an independent determinant of serum adiponectin (β = -0.52; 95% confidence interval: -0.73 to -0.31; p < 0.001). In the prospective analysis, after adjustment for confounders, changes in WC predicted changes in adiponectin. For each unit increase in WC, adiponectin declined by 0.39 mg/L (p < 0.001). This study demonstrates that WC is associated with adiponectin and, more importantly, that this simple marker of central adiposity was able to predict changes in adiponectin levels over time.

Higher waist-to-height ratio and waist circumference are predictive of metabolic syndrome and elevated serum alanine aminotransferase in adolescents and young adults in mainland China

The prevalence of overweight and obesity continue to increase among children and adolescents worldwide. This study examined whether waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) are predictive of metabolic syndrome and elevated serum alanine aminotransferase (ALT) among adolescents and young adults in mainland China. Cross-sectional study. In total, 6997 students aged 12-24 years from nine Chinese cities participated in this study. Anthropometric and biochemical data were collected. A logistic regression model was performed to determine the association between anthropometric indicators and metabolic syndrome components and abnormal liver function. This study found prevalence rates for the metabolic syndrome and elevated ALT of 1.4% and 3.1%, respectively, among adolescents and young adults in mainland China. A multivariate logistic regression model found that WHtR ≥0.50 was more strongly associated with metabolic syndrome components and elevated ALT than WC values at or above the 90th percentile (P(90)) or WHpR ≥P(90). Odds ratios for elevated ALT were 2.03 [95% confidence interval (CI) 1.46-2.81], 4.56 (95% CI 3.07-6.78) and 13.43 (95% CI 7.67-23.51) in adolescents and young adults with one, two and three or more components of metabolic syndrome, respectively (P<0.001 for all). Higher WC and WHtR were found to be predictive of metabolic syndrome components and elevated ALT among adolescents and young adults in mainland China, and the association was stronger for WHtR. Furthermore, adolescents and young adults with more metabolic syndrome components were more likely to suffer from elevated ALT.

Ratio of Waist-to-Calf Circumference and Carotid Atherosclerosis in Korean Patients With Type 2 Diabetes

OBJECTIVETo investigate whether waist circumference (WC), calf circumference (CC), and waist-to-calf ratio (WCR) are associated with carotid atherosclerosis in patients with type 2 diabetes.RESEARCH DESIGN AND METHODSThis was an observational study performed in 3,694 Korean patients with type 2 diabetes. Anthropometric measures and carotid ultrasound were performed on each subject. Carotid atherosclerosis was defined as having a clearly isolated focal plaque or mean carotid intima-media thickness (CIMT) ≥1.1 mm.RESULTSCIMT and the frequency of carotid atherosclerosis were higher with increasing WC quartiles and decreasing CC quartiles. There was an augmentative effect of CC and WC on the frequency of carotid atherosclerosis, which was dramatically higher in both the highest WC quartile and lowest CC quartile. However, except for the relationship between the quartile of CC with the frequency of carotid atherosclerosis in men, those associations disappeared after adjusting for potential confounders. In contrast, WCR was significantly related to CIMT (only in women) and carotid atherosclerosis, even after adjustment (adjusted odds ratio for carotid atherosclerosis for the highest quartile of WCR compared with the lowest quartile being 1.178 [95% CI 1.026–1.353] and 1.276 [1.053–1.545] in men and women, respectively).CONCLUSIONSA low CC and high WC seems to be associated with a carotid atherosclerotic burden in Korean diabetic patients. In particular, compared with each circumference, WCR is independently associated with carotid atherosclerosis. However, the cross-sectional nature of the study limits conclusions regarding the direction or causality. Further longitudinal study is warranted in this and other ethnic groups.

Is Waist Circumference a Better Predictor of Insulin Resistance Than Body Mass Index in U.S. Adolescents?

To determine whether waist circumference (WC) is a better predictor of insulin resistance (IR) than body mass index (BMI) in U.S. adolescents aged 12-18 years. Using data from the National Health and Nutrition Examination Survey 1999-2002, we evaluated an ethnically diverse sample of 1,571 adolescents with regard to BMI, WC, and fasting glucose and insulin levels. Children were classified as having IR if they had a homeostasis model assessment of insulin resistance (insulin [U/mL] × glucose [mmol/L]/22.5) of greater than 4.39.We created receiver operating characteristic curves predicting IR across various thresholds of WC and BMI, and area under the curve was compared. The prevalence rate of IR in the study population was 11.8%. Measures of test performance (sensitivity and specificity) for predicting IR were similar for abnormal BMI and WC thresholds; that is, thresholds of BMI 85th% and WC 75th% and thresholds of BMI 95th% and WC 90th% were quite similar. There were no significant differences in area under the curve for WC versus BMI (.85; 95% CI, .83-.88; p = .84) either for the overall population or for specific racial groups. WC does not seem to provide a distinct advantage over BMI for identifying adolescents with IR.

Should waist circumference be used to identify metabolic disorders than BMI in South Korea?

Although indicators of central obesity have been suggested as a better alternative to body mass index (BMI), yet mixed results exist. This study examined whether waist circumference (WC) was better in identifying metabolic disorders than BMI at two time points. This study used nationally representative 1998 and 2005 Korea National Health and Nutrition Examination Survey data sets. Odds ratios from logistic regressions and area under the curves (AUC) were calculated. BMI and WC showed similar level of odds ratios (1.1-1.6) to diabetes, hypertension, dyslipidemia and having two or three metabolic syndrome criteria. The AUC comparison, however, indicated that, in only women, WC was a better discriminator for diabetes, hypertension and having two or three metabolic syndrome criteria. No meaningful differences were found between 1998 and 2005. Prospective studies to weigh practical and clinical relevance are needed to assert the use of WC over BMI in clinical and public health settings.