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Comparative Study
. 2002 Oct;76(4):743-9.
doi: 10.1093/ajcn/76.4.743.

Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds

ShanKuan Zhu  1 , ZiMian Wang, Stanley Heshka, Moonseong Heo, Myles S Faith, Steven B Heymsfield
Affiliations
Comparative Study

Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds

ShanKuan Zhu et al. Am J Clin Nutr. 2002 Oct.

Abstract

Background: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m(2)).

Objective: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI.

Design: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of >or= 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI.

Results: At BMIs of 25 and 30, ORs were 1.19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI.

Conclusion: WC is more closely linked to cardiovascular disease risk factors than is BMI.

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Comment in

  • Waist worries.
    Lean MJ, Han TS. Lean MJ, et al. Am J Clin Nutr. 2002 Oct;76(4):699-700. doi: 10.1093/ajcn/76.4.699. Am J Clin Nutr. 2002. PMID: 12324279 Review. No abstract available.

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