title: Cardiometabolic risk factors and obesity: does it matter whether BMI or waist circumference is the index of obesity?
abstract: BACKGROUND
  It has been suggested that the cardiometabolic risk associated with excess adiposity is particularly related to central obesity.
  
  
  OBJECTIVE
  The objective was to compare the associations between cardiometabolic risk of apparently healthy individuals and measures of central obesity [waist circumference (WC)] and overall obesity [body mass index (BMI)].
  
  
  METHODS
  In this cross-sectional, observational study, 492 subjects (306 women and 303 non-Hispanic whites) were classified by BMI (in kg/m²) as normal weight (BMI <25) or overweight/obese (BMI = 25.0-34.9) and as having an abnormal WC (≥80 cm in women and ≥94 cm in men) or a normal WC (<80 cm in women and <94 cm in men). Measurements were also made of the cardiometabolic risk factors age, systolic blood pressure (SBP), and fasting plasma glucose (FPG), triglyceride, and high-density lipoprotein (HDL)-cholesterol concentrations. Associations among cardiometabolic risk factors and BMI and WC were evaluated with Pearson correlations.
  
  
  RESULTS
  There was a considerable overlap in the normal and abnormal categories of BMI and WC, and ~81% of the subjects had both an abnormal BMI and WC. In women, BMI and WC correlated with SBP (r = 0.30 and 0.19, respectively), FPG (r = 0.25 and 0.22, respectively), triglycerides (r = 0.17 and 0.20, respectively), and HDL cholesterol (r = -0.23 and -0.20, respectively) (P < 0.01 for all). In men, BMI and WC also correlated with SBP (r = 0.22 and 0.22, respectively), FPG (r = 0.22 and 0.25, respectively), triglycerides (r = 0.21 and 0.18, respectively), and HDL cholesterol (r = -0.20 and -0.13, respectively) [P < 0.05 for all, except for the association of WC with HDL cholesterol (P = 0.08)].
  
  
  CONCLUSIONS
  Most individuals with an abnormal BMI also have an abnormal WC. Both indexes of excess adiposity are positively associated with SBP, FPG, and triglycerides and inversely associated with HDL cholesterol.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine and the Department of Psychiatry, Stanford University School of Medicine, Stanford, CA 94305, USA. fahim@stanford.edu
authors.forename: Fahim
authors.initials: F
authors.lastname: Abbasi
authors.forename: Christine
authors.initials: C
authors.lastname: Blasey
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Reaven
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D012016:Reference Values; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides