title: Measurement of Waist Circumference: midabdominal or iliac crest?
abstract: OBJECTIVE
  Waist circumference (WC) is used to define central obesity. This study aimed to compare the performance of two recommended locations of WC measurement.
  
  
  METHODS
  A cohort of 1,898 subjects who were without diabetes from 2006 to 2012 were followed for a median of 31 months (Taiwan Lifestyle Study). The WC-IC, recommended by the National Cholesterol Education Program Third Adult Treatment Panel, was measured at the superior border of the iliac crest, and the WC-mid, recommended by World Health Organization and International Diabetes Federation, was measured midway between the lowest ribs and the iliac crest. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) were assessed by computed tomography.
  
  
  RESULTS
  There was greater difference between WC-IC and WC-mid measurements in women than in men (P < 0.001). Both WC-IC and WC-mid correlated significantly with BMI, VFA, and SFA (all P < 0.001). WC-mid was better correlated to VFA than WC-IC, particularly in women, and it correlated more strongly to blood pressure, plasma glucose, hemoglobin A1c, triglyceride levels, HDL cholesterol, and C-reactive protein (all P < 0.05). The association of WC-mid with hypertension, diabetes, and metabolic syndrome was slightly better than that of WC-IC (area under the receiver operator curve 0.7 vs. 0.69, 0.71 vs. 0.68, and 0.75 vs. 0.7, respectively; all age-adjusted P < 0.05). With 90 cm (male)/80 cm (female) as criteria for central obesity, WC-mid, but not WC-IC, predicted the incidence of diabetes development (age-adjusted P = 0.003).
  
  
  CONCLUSIONS
  WC-mid is a better measurement to define central obesity than WC-IC, particularly in women.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Cardinal Tien Hospital, Xindian, Taiwan.
authors.forename: Wen-Ya
authors.initials: WY
authors.lastname: Ma
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Yang
authors.forename: Shyang-Rong
authors.initials: SR
authors.lastname: Shih
authors.forename: Hong-Jen
authors.initials: HJ
authors.lastname: Hsieh
authors.forename: Chi Sheng
authors.initials: CS
authors.lastname: Hung
authors.forename: Fu-Chun
authors.initials: FC
authors.lastname: Chiu
authors.forename: Mao-Shin
authors.initials: MS
authors.lastname: Lin
authors.forename: Pi-Hua
authors.initials: PH
authors.lastname: Liu
authors.forename: Cyue-Huei
authors.initials: CH
authors.lastname: Hua
authors.forename: Yenh-Chen
authors.initials: YC
authors.lastname: Hsein
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
authors.forename: Jung-Nan
authors.initials: JN
authors.lastname: Wei
authors.forename: Hung-Yuan
authors.initials: HY
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis* / Q000378:metabolism; D050151:Subcutaneous Fat / Q000378:metabolism; D055105:Waist Circumference / Q000502:physiology*