Minimal versus umbilical waist circumference measures as indicators of cardiovascular disease risk.
OBJECTIVE
Measures of central obesity are strongly correlated with cardiovascular disease (CVD) risk. Although waist circumference (WC) is a commonly used measure of central obesity, there is no standard measurement location. We examined two WC locations to determine which was more highly correlated with CVD risk factors and metabolic syndrome (MS).


METHODS
WC measures were taken on 266 sedentary, overweight men and women 45 to 60 years old. Intravenous glucose tolerance tests, fasting plasma lipid analysis, and computed tomography scans were conducted. Correlational analyses followed by the Test for Equal Correlations determined whether one WC measure better correlated with the cardiovascular risk factors.


RESULTS
In women, minimal waist had higher correlation coefficients than umbilical waist for all eight variables presented. High-density lipoprotein-cholesterol, low-density lipoprotein particle size, and MS score were significantly correlated with minimal waist, but not umbilical waist. For high-density lipoprotein size and insulin sensitivity, minimal waist was a better correlate, although the difference between waist measures only approached statistical significance (p < 0.06). In men, minimal waist had a higher correlation coefficient than umbilical waist for insulin sensitivity, fasting insulin, and visceral adipose tissue. Additionally, minimal waist was significantly correlated with MS in men and umbilical waist was not. For both genders, minimal waist was more highly correlated with visceral adipose tissue than umbilical waist.


CONCLUSIONS
For every metabolic variable presented, minimal WC was more highly correlated with CVD risk than was umbilical WC in women. The data for women indicate that WC location is important when determining CVD risk. In men, minimal waist was better, although the data were less compelling.
Willis
Leslie H
LH
Division of Cardiology, Department of Medicine, Duke University Medical Center, P.O. Box 102903, Durham, NC 27710, USA. leslie.willis@duke.edu
Slentz
Cris A
CA
Houmard
Joseph A
JA
Johnson
Johanna L
JL
Duscha
Brian D
BD
Aiken
Lori B
LB
Kraus
William E
WE
D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D015444:Exercise; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D012307:Risk Factors; D040242:Risk Reduction Behavior; D049629:Waist-Hip Ratio / Q000379:methods*
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids