Preventive cardiology| Volume 102, ISSUE 1, P40-46, July 01, 2008

Download started.


Comparison of Waist Circumference Versus Body Mass Index in Diagnosing Metabolic Syndrome and Identifying Apparently Healthy Subjects at Increased Risk of Cardiovascular Disease

      The goal of this study was to compare the impact of differences in waist circumference (WC) defined according to the International Diabetes Federation (IDF) and the Adult Treatment Panel III (ATP III) and body mass index (BMI) on cardiovascular disease risk factors in 402 apparently healthy volunteers of European ancestry. Consequently, measurements were made of the WC, BMI, blood pressure, glucose, and lipid components of metabolic syndrome (MS) and insulin-mediated glucose uptake. Subjects were divided according to WC (IDF and ATP III criteria) and by normal weight, overweight, or obesity using BMI, and comparisons were made of the effect of these different indexes of adiposity on cardiovascular disease risk factors. The results indicated that WC and BMI significantly correlated (p <0.001) and were associated with differences in insulin-mediated glucose uptake to a similar degree in men (r = 0.57 and r = 0.59) and women (r = 0.53 and r = 0.52). Prevalences of MS were essentially identical irrespective of the measure of WC used (ATP III vs IDF), as were metabolic characteristics of those classified using IDF or ATP III criteria. Cardiovascular disease risk factor status did not vary substantially when subjects were divided on the basis of WC or BMI. In conclusion, prevalences of MS or cardiovascular disease risk factors did not vary as a function of differences in IDF and ATP III criteria for WC. BMI identified individuals at increased cardiovascular disease risk as effectively as determination of WC.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).
        JAMA. 2001; 285: 2486-2497
        • Alberti K.G.
        • Zimmet P.
        • Shaw J.
        The metabolic syndrome—a new worldwide definition.
        Lancet. 2005; 366: 1059-1062
      2. Diagnosis and classification of diabetes mellitus.
        Diabetes Care. 2008; 31: S55-S60
      3. Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94.
        Vital Health Stat 1. 1994; : 1-407
      4. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report.
        Obes Res. 1998; 6: S51-S209
        • Pei D.
        • Jones C.N.
        • Bhargava R.
        • Chen Y.D.
        • Reaven G.M.
        Evaluation of octreotide to assess insulin-mediated glucose disposal by the insulin suppression test.
        Diabetologia. 1994; 37: 843-845
        • Shen S.W.
        • Reaven G.M.
        • Farquhar J.W.
        Comparison of impedance to insulin-mediated glucose uptake in normal subjects and in subjects with latent diabetes.
        J Clin Invest. 1970; 49: 2151-2160
        • Greenfield M.S.
        • Doberne L.
        • Kraemer F.
        • Tobey T.
        • Reaven G.
        Assessment of insulin resistance with the insulin suppression test and the euglycemic clamp.
        Diabetes. 1981; 30: 387-392
        • Yip J.
        • Facchini F.S.
        • Reaven G.M.
        Resistance to insulin-mediated glucose disposal as a predictor of cardiovascular disease.
        J Clin Endocrinol Metab. 1998; 83: 2773-2776
        • Facchini F.S.
        • Hua N.
        • Abbasi F.
        • Reaven G.M.
        Insulin resistance as a predictor of age-related diseases.
        J Clin Endocrinol Metab. 2001; 86: 3574-3578
        • Lorenzo C.
        • Serrano-Rios M.
        • Martinez-Larrad M.T.
        • Gonzalez-Sanchez J.L.
        • Seclen S.
        • Villena A.
        • Gonzalez-Villalpando C.
        • Williams K.
        • Haffner S.M.
        Geographic variations of the International Diabetes Federation and the National Cholesterol Education Program-Adult Treatment Panel III definitions of the metabolic syndrome in nondiabetic subjects.
        Diabetes Care. 2006; 29: 685-691
        • Saely C.H.
        • Koch L.
        • Schmid F.
        • Marte T.
        • Aczel S.
        • Langer P.
        • Hoefle G.
        • Drexel H.
        Adult Treatment Panel III 2001 but not International Diabetes Federation 2005 criteria of the metabolic syndrome predict clinical cardiovascular events in subjects who underwent coronary angiography.
        Diabetes Care. 2006; 29: 901-907
        • Qiao Q.
        Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women.
        Diabetologia. 2006; 49: 2837-2846
        • Ford E.S.
        • Mokdad A.H.
        • Giles W.H.
        Trends in waist circumference among U.S. adults.
        Obes Res. 2003; 11: 1223-1231
        • Farin H.M.
        • Abbasi F.
        • Reaven G.M.
        Body mass index and waist circumference correlate to the same degree with insulin-mediated glucose uptake.
        Metabolism. 2005; 54: 1323-1328
        • Reaven G.M.
        The metabolic syndrome: requiescat in pace.
        Clin Chem. 2005; 51: 931-938
        • Kissebah A.H.
        • Vydelingum N.
        • Murray R.
        • Evans D.J.
        • Hartz A.J.
        • Kalkhoff R.K.
        • Adams P.W.
        Relation of body fat distribution to metabolic complications of obesity.
        J Clin Endocrinol Metab. 1982; 54: 254-260
        • Sparrow D.
        • Borkan G.A.
        • Gerzof S.G.
        • Wisniewski C.
        • Silbert C.K.
        Relationship of fat distribution to glucose tolerance.
        Diabetes. 1986; 35: 411-415
        • Bjorntorp P.
        Adipose tissue distribution, plasma insulin, and cardiovascular disease.
        Diabetes Metab. 1987; 13: 381-385
        • Despres J.P.
        • Nadeau A.
        • Tremblay A.
        • Ferland M.
        • Moorjani S.
        • Lupien P.J.
        • Theriault G.
        • Pinault S.
        • Bouchard C.
        Role of deep abdominal fat in the association between regional adipose tissue distribution and glucose tolerance in obese women.
        Diabetes. 1989; 38: 304-309
        • Pouliot M.C.
        • Despres J.P.
        • Nadeau A.
        • Moorjani S.
        • Prud'Homme D.
        • Lupien P.J.
        • Tremblay A.
        • Bouchard C.
        Visceral obesity in men.
        Diabetes. 1992; 41: 826-834
        • Rexrode K.M.
        • Buring J.E.
        • Manson J.E.
        Abdominal and total adiposity and risk of coronary heart disease in men.
        Int J Obes Relat Metab Disord. 2001; 25: 1047-1056
        • Lee J.
        • Ma S.
        • Heng D.
        • Tan C.E.
        • Chew S.K.
        • Hughes K.
        • Tai E.S.
        Should central obesity be an optional or essential component of the metabolic syndrome?.
        Diabetes Care. 2007; 30: 343-347
        • Tulloch-Reid M.K.
        • Williams D.E.
        • Looker H.C.
        • Hanson R.L.
        • Knowler W.C.
        Do measures of body fat distribution provide information on the risk of type 2 diabetes in addition to measures of general obesity?.
        Diabetes Care. 2003; 26: 2556-2561
        • Haffner S.M.
        • Stern M.P.
        • Mitchell B.D.
        • Hazuda H.P.
        • Patterson J.K.
        Incidence of type II diabetes in Mexican Americans predicted by fasting insulin and glucose levels, obesity, and body-fat distribution.
        Diabetes. 1990; 39: 283-288
        • Seidell J.C.
        • Cigolini M.
        • Deslypere J.P.
        • Charzewska J.
        • Ellsinger B.M.
        • Cruz A.
        Body fat distribution in relation to serum lipids and blood pressure in 38-year-old European men: the European fat distribution study.
        Atherosclerosis. 1991; 86: 251-260
        • Folsom A.R.
        • Li Y.
        • Rao X.
        • Cen R.
        • Zhang K.
        • Liu X.
        • He L.
        • Irving S.
        • Dennis B.H.
        Body mass, fat distribution and cardiovascular risk factors in a lean population of south China.
        J Clin Epidemiol. 1994; 47: 173-181
        • Sakurai Y.
        • Kono S.
        • Shinchi K.
        • Honjo S.
        • Todoroki I.
        • Wakabayashi K.
        • Imanishi K.
        • Nishikawa H.
        • Ogawa S.
        • Katsurada M.
        Relation of waist-hip ratio to glucose tolerance, blood pressure, and serum lipids in middle-aged Japanese males.
        Int J Obes Relat Metab Disord. 1995; 19: 632-637
        • Schmidt M.I.
        • Duncan B.B.
        • Watson R.L.
        • Sharrett A.R.
        • Brancati F.L.
        • Heiss G.
        A metabolic syndrome in whites and African-Americans.
        Diabetes Care. 1996; 19: 414-418