title: [Distribution of waist circumference and waist-to-height ratio by categories of body mass index in patients attended in endocrinology and nutrition units].
abstract: BACKGROUND
  Waist circumference (WC) and the waist-to-height ratio (WHtR) are anthropometric measures widely used in clinical practice to evaluate visceral fat and the consequent cardiovascular risk. However, risk thresholds should be standardized according to body mass index (BMI).
  
  
  OBJECTIVE
  To determine the distribution of WC and WHtR according to the BMI cut-points currently used to describe overweight and obesity.
  
  
  METHODS
  WC, WHtR and BMI were measured in 3521 adult patients (>18 years) attended in Endocrinology and Nutrition units.
  
  
  RESULTS
  A total of 20.8% (734 patients) were diabetic. Obesity was found in 82.1% of diabetic patients and in 75% of non-diabetic patients. The WC thresholds proposed by the National Institute of Health (102 cm in men, 88 cm in women), Bray (100 cm in men, 90 cm in women) and the International Diabetes Federation (94 cm in men, 80 cm in women) were exceeded by 92.9%, 94.8% and 98.4% of obese men, 96.8%, 95.5% and 99.7% of obese women, 79.1%, 83.1% and 90% of diabetic men and 95.5%, 81.5% and 97.4% of diabetic women, respectively. Thresholds adapted to the degree of obesity (90, 100, 110 and 125 cm in men and 80, 90, 105 and 115cm in women for normal BMI, overweight, obesity I and obesity greater than I) were exceeded by 58.4% of obese men, 54.2% of obese women, 57.5% of diabetic men and 60.7% of diabetic women. WC was higher in men, and BMI and the WHtR were higher in women. The WC of diabetic women equalled that of men, and WC, WHtR and BMI were higher in diabetic than in non-diabetic women (p<0.001). WC (p<0.005), WHtR (p<0.001) and BMI (p<0.5) were also higher in diabetic than in non-diabetic men.
  
  
  CONCLUSIONS
  WC and WHtR thresholds by BMI discriminated diabetic and obese patients better than single thresholds, and can be represented graphically by the distribution of percentile ranks of WC and WHtR by BMI.ik.
authors.affiliation: Sección Endocrinología, Hospital Virgen de las Nieves, Granada, Spain. mcasares01-revistas@yahoo.es
authors.forename: Martín
authors.initials: M
authors.lastname: López De La Torre
authors.forename: Diego
authors.initials: D
authors.lastname: Bellido Guerrero
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal Cortada
authors.forename: Alfonso
authors.initials: A
authors.lastname: Soto González
authors.forename: Katherinne
authors.initials: K
authors.lastname: García Malpartida
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernandez-Mijares
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D015992:Body Mass Index; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D012306:Risk; D013030:Spain / Q000453:epidemiology; D055105:Waist Circumference; D055815:Young Adult