Optimal central obesity measurement site for assessing cardiometabolic and type 2 diabetes risk in middle-aged adults

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dc.contributor.author Millar, Sean R.
dc.contributor.author Perry, Ivan J.
dc.contributor.author Van den Broeck, Jan
dc.contributor.author Phillips, Catherine M.
dc.date.accessioned 2016-02-17T10:07:58Z
dc.date.available 2016-02-17T10:07:58Z
dc.date.issued 2015
dc.identifier.citation Millar SR, Perry IJ, Broeck JVd, Phillips CM (2015) Optimal Central Obesity Measurement Site for Assessing Cardiometabolic and Type 2 Diabetes Risk in Middle-Aged Adults. PLoS ONE 10(6): e0129088. doi:10.1371/journal.pone.0129088
dc.identifier.volume 10 en
dc.identifier.issued 6 en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/2307
dc.identifier.doi 10.1371/journal.pone.0129088
dc.description.abstract Objectives: Despite recommendations that central obesity assessment should be employed as a marker of cardiometabolic health, no consensus exists regarding measurement protocol. This study examined a range of anthropometric variables and their relationships with cardiometabolic features and type 2 diabetes in order to ascertain whether measurement site influences discriminatory accuracy. In particular, we compared waist circumference (WC) measured at two sites: (1) immediately below the lowest rib (WC rib) and (2) between the lowest rib and iliac crest (WC midway), which has been recommended by the World Health Organisation and International Diabetes Federation. Materials and Methods: This was a cross-sectional study involving a random sample of 2,002 men and women aged 46-73 years. Metabolic profiles and WC, hip circumference, pelvic width and body mass index (BMI) were determined. Correlation, logistic regression and area under the receiver operating characteristic curve analyses were used to evaluate obesity measurement relationships with metabolic risk phenotypes and type 2 diabetes. Results: WC rib measures displayed the strongest associations with non-optimal lipid and lipoprotein levels, high blood pressure, insulin resistance, impaired fasting glucose, a clustering of metabolic risk features and type 2 diabetes, in both genders. Rib-derived indices improved discrimination of type 2 diabetes by 3-7% compared to BMI and 2-6% compared toWC midway (in men) and 5-7% compared to BMI and 4-6% compared to WC midway (in women). A prediction model including BMI and central obesity displayed a significantly higher area under the curve for WC rib (0.78, P=0.003), Rib/height ratio (0.80, P<0.001), Rib/pelvis ratio (0.79, P<0.001), but not for WC midway (0.75, P=0.127), when compared to one with BMI alone (0.74). Conclusions: WC rib is easier to assess and our data suggest that it is a better method for determining obesity-related cardiometabolic risk than WC midway. The clinical utility of rib-derived indices, or alternative WC measurements, deserves further investigation. en
dc.description.sponsorship Health Research Board (HRC/2007/13) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights © 2015 Millar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Body mass index en
dc.subject To-height ratio en
dc.subject American Heart Association en
dc.subject Waist circumference en
dc.subject Cardiovascular risk en
dc.subject Metabolic syndrome en
dc.subject Anthropometric indicators en
dc.subject Consensus statement en
dc.subject Insulin resistance en
dc.subject Fat distribution en
dc.title Optimal central obesity measurement site for assessing cardiometabolic and type 2 diabetes risk in middle-aged adults en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Ivan Perry, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: i.perry@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.internal.wokid WOS:000355701600086
dc.contributor.funder Health Research Board
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLOS ONE en
dc.internal.IRISemailaddress i.perry@ucc.ie en
dc.identifier.articleid e0129088


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© 2015 Millar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Except where otherwise noted, this item's license is described as © 2015 Millar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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