title: Relationship of abdominal obesity with cardiovascular disease, diabetes and hyperlipidaemia in Spain.
abstract: OBJECTIVE
  To evaluate the relevance of obesity and abdominal obesity in the prevalence of cardiovascular disease (CVD), diabetes mellitus, hyperlipidaemia and hypertension in primary care patients and to ascertain whether waist circumference (WC) measurement should be included in routine clinical practice in addition to body mass index (BMI).
  
  
  METHODS
  As part of the IDEA study, primary care physicians from Spain recruited patients aged 18-80 years. WC and BMI and the presence of CVD, diabetes mellitus, hyperlipidaemia and hypertension were recorded. Finally, 17 980 were analysed. An age-related increase in adiposity was observed. Overall 33% were obese by BMI, and 51% of subjects presented abdominal obesity by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) (WC > 102 cm for men and > 88 cm for women). Although there was a correlation between BMI and WC, they presented different distribution patterns. Women, but not men, with a high level of education, professional activity and smoking were associated with a lower WC. Abdominal obesity was significantly associated with CVD. Some subjects with abdominal obesity but lean by BMI, showed an increased prevalence of CVD and diabetes. Furthermore, abdominal obesity was strongly associated with dyslipidaemia and hypertension.
  
  
  CONCLUSIONS
  Half of the primary care patients studied showed abdominal obesity as measured by WC, whereas one-third was obese by BMI. Abdominal obesity was strongly associated with CVD and diabetes, even in patients lean by BMI. WC should be included in the routine clinical practice in addition to BMI.
authors.affiliation: Department of Medicine, Endocrine Division, Complejo Hospitalario Universitario, Santiago de Compostela University, Centro de Investigación Biomédica en Red, Fisiopatología de Obesidad & Nutrición (CIBERobn), Santiago de Compostela, Spain.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.forename: Basilio
authors.initials: B
authors.lastname: Moreno
authors.forename: Rosario
authors.initials: R
authors.lastname: Rodríguez-Azeredo
authors.forename: Christine
authors.initials: C
authors.lastname: Massien
authors.forename: Pedro
authors.initials: P
authors.lastname: Conthe
authors.forename: Xavier
authors.initials: X
authors.lastname: Formiguera
authors.forename: Vivencio
authors.initials: V
authors.lastname: Barrios
authors.forename: Beberly
authors.initials: B
authors.lastname: Balkau
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology*; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000453:epidemiology; D055105:Waist Circumference