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

dc.contributor.authorMillar, Sean R.
dc.contributor.authorPerry, Ivan J.
dc.contributor.authorVan den Broeck, Jan
dc.contributor.authorPhillips, Catherine M.
dc.contributor.funderHealth Research Board
dc.date.accessioned2016-02-17T10:07:58Z
dc.date.available2016-02-17T10:07:58Z
dc.date.issued2015
dc.description.abstractObjectives: 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.sponsorshipHealth Research Board (HRC/2007/13)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide0129088
dc.identifier.citationMillar 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.doi10.1371/journal.pone.0129088
dc.identifier.issn1932-6203
dc.identifier.issued6en
dc.identifier.journaltitlePLOS ONEen
dc.identifier.urihttps://hdl.handle.net/10468/2307
dc.identifier.volume10en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
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 crediteden
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectBody mass indexen
dc.subjectTo-height ratioen
dc.subjectAmerican Heart Associationen
dc.subjectWaist circumferenceen
dc.subjectCardiovascular risken
dc.subjectMetabolic syndromeen
dc.subjectAnthropometric indicatorsen
dc.subjectConsensus statementen
dc.subjectInsulin resistanceen
dc.subjectFat distributionen
dc.titleOptimal central obesity measurement site for assessing cardiometabolic and type 2 diabetes risk in middle-aged adultsen
dc.typeArticle (peer-reviewed)en
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