Race-ethnicity-specific waist circumference cutoffs for identifying cardiovascular disease risk factors.

BACKGROUND: Waist circumferences (WCs) in white men and women that represent a risk of cardiovascular disease (CVD) equivalent to that of body mass indexes (BMIs; in kg/m2) of 25 and 30 have been identified. However, WC cutoffs for other race-ethnicity groups remain unknown. OBJECTIVE: The objective was to determine WC cutoffs for CVD risk in non-Hispanic blacks (blacks), Mexican Americans (MA), and non-Hispanic whites (whites). DESIGN: Data from 10,969 participants in the third National Health and Nutrition Examination Survey (1988-1994) were analyzed. The presence of CVD risk factors was the main outcome. Sex- and race-ethnicity-specific WC cutoffs were determined with logistic regression models by linking WC cutoffs with equivalent CVD risk based on BMI cutoffs for overweight and obesity. WC cutoffs for metabolic syndrome risk factors were similarly calculated. RESULTS: Correlations between WC and lipid profiles, blood pressure, and glucose were significantly higher than those between BMI and these same variables in all groups. The WC cutoffs were approximately 5-6 cm greater for white than for black men at BMIs between 25 and 40, and those for MA were intermediate. In women, few differences in WC cutoffs were observed between the groups. Simplified WC cutoffs corresponding to BMIs of 25 and 30, largely independent of age, for the 3 race-ethnicity groups were 89 and 101 cm for men and 83 and 94 cm for women. Minimal distances in receiver operating characteristic curves tended to be shorter when WC cutoffs rather than BMI cutoffs were used. CONCLUSIONS: WC is a better indicator of CVD risk than is BMI in the 3 race-ethnicity groups studied. The proposed WC cutoffs are more sensitive than are BMI cutoffs in predicting CVD risk

Body Mass Index can Similarly Predict the Presence of Multiple Cardiovascular Risk Factors in Middle-aged Japanese Subjects as Waist Circumference

ObjectiveAdiposity is closely associated with the clustering of metabolic risk factors such as high bloodpressure, dyslipidemia, and glucose intolerance. Waist circumference and body mass index (BMI) are the es-tablished markers of abdominal adiposity and general adiposity, respectively. However, it has not been exam-ined whether these two markers can detect the clustering of metabolic risk factors in Japanese subjects.Methods and ResultsWe studied 5,796 Japanese middle-aged subjects aged 40-60 years (4,344 males and1,452 females). Metabolic risk factors including highblood pressure, dyslipidemia, and glucose intolerancewere identified according to the diagnostic criteria for metabolic syndrome in Japan. The number of meta-bolic risk factors was significantly associated withthe BMI values in both male and female subjects. Theprevalence of subjects with multiple (two or more) metabolic risk factors was 29.4% and 7.6% in males andfemales, respectively. According to receiver operating characteristic (ROC) analysis, the area under curve val-ues of BMI and waist circumference did not differ in male (0.658 vs. 0.671, p=n.s.) and female (0.776 vs.0.790, p=n.s.) subjects, indicating that the waist circumference as well as the BMI could be useful in detect-ing the occurrence of multiple metabolic risk factors. The appropriate cut-off values of BMI to predict thepresence of multiple metabolic risk factors were 24.7 and 23.4 kg/m2in males and females, respectively. Thesensitivity and specificity using these cut-off values were 58 and 65% in males and 65 and 77% in females,respectively.ConclusionThe BMI values can similarly predict the presence of multiple metabolic risk factors just as thewaist circumference in Japanese middle-aged subjects