title: Measurement error and ethnic comparisons of measures of abdominal obesity.
abstract: BACKGROUND
  Methods of estimating central obesity are important because of the increasing frequency of obesity related diseases worldwide. Here we evaluate the precision of measuring waist circumference and the waist to hip ratio with comparisons across ethnic groups.
  
  
  METHODS
  The third Australian Risk Factor Prevalence Study (1989) of 9279 adults recorded height, weight, and Body Mass Index together with duplicate measurements of the waist and hip circumferences, the waist to hip ratio, and blood pressure levels using clearly defined survey techniques. Measurement error and precision for these variables were calculated, and comparisons were made across ethnic groups.
  
  
  RESULTS
  Coefficients of variation for the waist circumference and the waist to hip ratio were less than 1% indicating good precision in comparison with quite large variability for systolic and diastolic pressure readings. Waist circumference showed increased variability in subjects with larger body build in comparison with waist to hip ratio. Equivalence tests across ethnic groups indicated that the waist to hip ratio was independent of ethnicity.
  
  
  CONCLUSIONS
  Waist to hip ratio provides a superior measure of central obesity with low measurement error, high precision, and no bias over a wide range of ethnic groups. We believe that it is essential to standardize methods in the assessment of central obesity. Assessment criteria should be based on waist to hip ratio rather than waist circumference.
authors: School of Public Health, Curtin Health Innovation Research Institute, Australian Technology Network Centre for Metabolic Fitness, Curtin University of Technology, Bentley, Western Australia, Australia. s.dhaliwal@curtin.edu.au
authors: Satvinder S
authors: SS
authors: Dhaliwal
authors: Timothy A
authors: TA
authors: Welborn
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001794:Blood Pressure; D015331:Cohort Studies; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis* / Q000208:ethnology*; D011237:Predictive Value of Tests; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult