title: Validity of self-reported abdominal obesity in Thai adults: a comparison of waist circumference, waist-to-hip ratio and waist-to-stature ratio.
abstract: OBJECTIVE
  Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio (WSR), being common proxy measures of abdominal obesity, are useful tools in epidemiologic studies, but little is known about their validity when the indices are derived from self-reported measurements. We determine and compare the validity of self-reported WC, WHR and WSR in order to identify the optimal index for use in epidemiologic surveys.
  
  
  RESULTS
  Technician- and self-reported measurements of height, waist and hip circumference were obtained from 613 Thai adults (mean age 35 years). Regarding technician-reported measurements as reference, diagnostic test properties were derived and performances of the indices compared using receiver-operator-characteristic curves and the area-under-the-curve (AUC) analyses. There was good agreement between technician- and self-reported measurements for WC and WSR (concordance correlation coefficients ranged from 0.84 to 0.90) but not for WHR (0.50 in men, 0.45 in women). The sensitivity and specificity of self-reported WC and self-reported WSR as measures of abdominal obesity were superior to those of self-reported WHR in both sexes. AUCs for WC and WSR were comparable (0.93 and 0.92, respectively, in men; 0.88 and 0.87 in women) and significantly higher than for WHR (0.80 in men; 0.76 in women; p<0.0001).
  
  
  CONCLUSIONS
  WC and WSR derived from self-reported waist and height measurements are valid methods for determining abdominal obesity. Self-reported measurements should not be used to derive the WHR. In Asian populations, WSR may be the optimal index of abdominal obesity when measurements are derived from self-reports in epidemiologic surveys.
authors.affiliation: National Centre for Epidemiology and Public Health, Mills Road, Australian National University, Acton ACT 0200, Australia. lynette.lim@anu.edu.au
authors.forename: L L-Y
authors.initials: LL
authors.lastname: Lim
authors.forename: Sam-ang
authors.initials: SA
authors.lastname: Seubsman
authors.forename: A
authors.initials: A
authors.lastname: Sleigh
authors.forename: C
authors.initials: C
authors.lastname: Bain
mesh_terms: D000328:Adult; D044466:Asian People; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology*; D012372:ROC Curve; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult