title: Abdominal obesity and the spectrum of global cardiometabolic risks in US adults.
abstract: OBJECTIVE
  To compare the association of obesity and abdominal obesity with cardiometabolic risk factor burden and global estimated coronary heart disease (CHD) risk among multiethnic US adults.
  
  
  METHODS
  Cross-sectional, survey study.
  
  
  METHODS
  A total of 4456 participants (representing 194.9 million adults) aged 20-79 years in the 2003-2004 National Health and Nutrition Examination Survey (NHANES).
  
  
  METHODS
  Body mass index (BMI) and waist circumference (WC) measures, CHD risk factors and a 10-year estimated CHD risk based on Framingham algorithms. Obesity was defined as a BMI >or=30 kg/m(2) and abdominal obesity as a WC >88 cm in women and >102 cm in men. High CHD risk status included diabetes, cardiovascular disease (CVD) or a 10-year Framingham risk score of >20%.
  
  
  RESULTS
  Overall, abdominal obesity was present in 42.3% of men and 62.5% of women and in 53.6% of whites, 56.9% of blacks and 50.5% of Hispanics (P<0.001 between gender and ethnicity). However, using International Diabetes Federation (IDF)-recommended WC cut points for Hispanics, the prevalence of abdominal obesity was 78.3%. Mean levels of low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure, fasting glucose and C-reactive protein increased, and high-density lipoprotein cholesterol (HDL-C) decreased (P<0.001) according to BMI and WC categories, although these associations were attenuated in blacks for blood pressure, LDL-C, HDL-C and triglycerides. Of those with high WC, 25-35% had >or=3 cardiometabolic risk factors. High CHD risk among those with high WC was most common in men (27.9%) and non-Hispanic whites (23.9%). Persons with a high vs normal WC, adjusted for age, gender, ethnicity and BMI were more likely to have >or=3 cardiometabolic risk factors (odds ratio (OR)=5.1, 95% confidence interval (CI)=3.9-6.6) and were classified as high CHD risk (OR=1.5, 95% CI=1.1-2.0).
  
  
  CONCLUSIONS
  The association of abdominal obesity with risk factors varies by ethnicity and is independently associated with high CHD risk status, further validating its clinical significance.
authors.affiliation: Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA 92697, USA.
authors.forename: H
authors.initials: H
authors.lastname: Ghandehari
authors.forename: V
authors.initials: V
authors.lastname: Le
authors.forename: S
authors.initials: S
authors.lastname: Kamal-Bahl
authors.forename: S L
authors.initials: SL
authors.lastname: Bassin
authors.forename: N D
authors.initials: ND
authors.lastname: Wong
mesh_terms: D050153:Abdominal Fat / Q000502:physiology*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology*; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D055815:Young Adult