title: Abdominal adiposity and clustering of multiple metabolic syndrome in White, Black and Hispanic americans.
abstract: OBJECTIVE
  The aim of this study was to evaluate the association of abdominal adiposity assessed by waist circumference (WC) with clustering of multiple metabolic syndromes (MMS) in White, Black and Hispanic Americans. MMS was defined as the occurrence of two or more of either hypertension, type 2 diabetes mellitus, dyslipidemia, hypertriglyceridemia or hyperinsulinemia.
  
  
  METHODS
  The number of MMS and fasting insulin (a surrogate measure of MMS) were each used as dependent variables in gender-specific multiple linear regression models, adjusting for age, smoking and alcohol intake. The contribution of WC to interethnic differences in clustering of MMS and fasting insulin concentration was assessed in gender-specific linear regression models. The risk of MMS due to large waist was estimated by comparing odds ratio for men with WC >/= 102 cm with those with WC < 102, and women with WC >/= 88 cm with women with WC < 88 cm in the logistic regression model adjusting for age, smoking and alcohol intake.
  
  
  RESULTS
  WC was positively and independently associated with clustering of MMS and increased fasting insulin concentration adjusting for age, smoking and alcohol intake in the three ethnic groups (p < 0.01). Black ethnicity was associated with clustering of MMS and fasting insulin concentration (p < 0.01). Hispanic ethnicity was also associated with clustering of MMS in men and associated with fasting insulin concentration in both men and women (p < 0.01). In both men and women, the risk of MMS clustering was strongly associated with increased WC in all ethnic groups independent of BMI.
  
  
  CONCLUSIONS
  WC appears to be a marker for multiple metabolic syndromes in these ethnic groups. The results of this investigation lend support to the view that waist measurement should be considered as a clinical variable for assessing the risk of cardiovascular diseases.
authors.affiliation: Department of Community Medicine, Mercer University School of Medicine, Macon, GA 31207, USA. okosun_j@mercer.edu
authors.forename: I S
authors.initials: IS
authors.lastname: Okosun
authors.forename: Y
authors.initials: Y
authors.lastname: Liao
authors.forename: C N
authors.initials: CN
authors.lastname: Rotimi
authors.forename: T E
authors.initials: TE
authors.lastname: Prewitt
authors.forename: R S
authors.initials: RS
authors.lastname: Cooper
mesh_terms: D000005:Abdomen; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000704:Analysis of Variance; D001824:Body Constitution; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology*; D006949:Hyperlipidemias / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D015228:Hypertriglyceridemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D013577:Syndrome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*