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Waist circumference, waist-hip ratio and BMI and their correlation with cardiovascular risk factors in Australian adults
journal contribution
posted on 2003-12-01, 00:00 authored by M Dalton, Adrian CameronAdrian Cameron, P Zimmet, J Shaw, Damien Jolley, David DunstanDavid Dunstan, T WelbornObjectives. To compare body mass index (BMI), waist circumference and waist–hip ratio (WHR) as indices of obesity and assess the respective associations with type 2 diabetes, hypertension and dyslipidaemia.
Design and setting. A national sample of 11 247 Australians aged ≥25 years was examined in 2000 in a cross-sectional survey.
Main outcome measures. The examination included a fasting blood sample, standard 2-h 75-g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity.
Results. The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior.
Conclusions. Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age-adjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.
Design and setting. A national sample of 11 247 Australians aged ≥25 years was examined in 2000 in a cross-sectional survey.
Main outcome measures. The examination included a fasting blood sample, standard 2-h 75-g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity.
Results. The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior.
Conclusions. Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age-adjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.
History
Journal
Journal of internal medicineVolume
254Issue
6Pagination
555 - 563Publisher
Blackwell Scientific PublicationsLocation
Oxford, EnglandPublisher DOI
ISSN
0954-6820eISSN
1365-2796Language
engPublication classification
C1.1 Refereed article in a scholarly journal; C Journal articleCopyright notice
2003, Blackwell PublishingUsage metrics
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No categories selectedKeywords
body mass indexbody sizeobesitywaist circumferencewaist–hip ratioScience & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal Medicinewaist-hip ratioADIPOSE-TISSUE ACCUMULATIONSIMPLE ANTHROPOMETRIC INDEXESDIABETES-MELLITUSFAT DISTRIBUTIONOBESE WOMENWEIGHT-GAINLIFE-STYLEMENASSOCIATIONOVERWEIGHTAusDiab Steering Committee
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