title: Usefulness of measuring both body mass index and waist circumference for the estimation of visceral adiposity and related cardiometabolic risk profile (from the INSPIRE ME IAA study).
abstract: Despite its well-documented relation with visceral adiposity (VAT) and cardiometabolic risk (CMR), whether waist circumference (WC) should be measured in addition to body mass index (BMI) remains debated. This study tested the relevance of adding WC to BMI for the estimation of VAT and CMR. In the International Study of Prediction of Intra-abdominal Adiposity and Its Relationship with Cardiometabolic Risk/Intra-abdominal Adiposity, 297 physicians recruited 4,504 patients (29 countries). Both BMI and WC were measured, whereas VAT and liver fat were assessed by computed tomography. A composite CMR score was calculated. From the 4,109 patients included in the present analyses (20 ≤ BMI < 40 kg/m(2), 47% women), about 30% displayed discordant values for WC and BMI quintiles, despite a strong correlation between the 2 anthropometric variables (r = 0.87 and r = 0.84 for men and women, respectively, p <0.001). Within each single BMI unit, VAT and WC showed substantial variability between subjects (mean difference between 90th and 10th percentiles: 175 cm(2)/16 cm and 137 cm(2)/18 cm for VAT/WC in men and women, respectively). Within each BMI category, increasing gender-specific WC tertiles were associated with significantly higher VAT, liver fat, and with a more adverse CMR profile. In conclusion, this large international cardiometabolic study highlights the frequent discordance between BMI and WC, driven by the substantial variability in VAT for a given BMI. Within each BMI category, WC was cross-sectionally associated with VAT, liver fat, and CMR factors. Thus, WC allows a further refinement of the CMR related to any given BMI.
authors.affiliation: Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada; CENS, CARMEN Laboratory INSERM U1060-INRA 1235, Pierre-Bénite, France.
authors.forename: Julie-Anne
authors.initials: JA
authors.lastname: Nazare
authors.affiliation: Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada; Harvard School of Public Health, Department of Nutrition, Boston, Massachusetts.
authors.forename: Jessica
authors.initials: J
authors.lastname: Smith
authors.affiliation: HP2 laboratory INSERM U1042, Hôpital Universitaire de Grenoble, Pôle DIGI-DUNE, Département d'endocrinologie, Diabétologie, Maladie de la Nutrition, Grenoble, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Borel
authors.affiliation: Javeriana University School of Medicine, Ignacio University Hospital, Bogotá, Colombia.
authors.forename: Pablo
authors.initials: P
authors.lastname: Aschner
authors.affiliation: Centre for Vascular Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Phil
authors.initials: P
authors.lastname: Barter
authors.affiliation: Department of Endocrinology, Diabetology, Metabolism and Clinical Nutrition, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Gaal
authors.affiliation: Gleneagles Medical Centre, Singapore.
authors.forename: Chee Eng
authors.initials: CE
authors.lastname: Tan
authors.affiliation: Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
authors.affiliation: Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.affiliation: School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Ross
authors.affiliation: Sanofi, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Brulle-Wohlhueter
authors.affiliation: Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Alméras
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
authors.affiliation: INSERM, CESP Centre for Research in Epidemiology and Population Health, UMRS 1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease over the Lifecourse and Determinants of Early Nutrition, Villejuif, University Paris Sud 11, Paris, France.
authors.forename: Beverley
authors.initials: B
authors.lastname: Balkau
authors.affiliation: Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada. Electronic address: jean-pierre.despres@criucpq.ulaval.ca.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000000981:diagnostic imaging; D056128:Obesity, Abdominal / Q000175:diagnosis* / Q000000981:diagnostic imaging; D050177:Overweight / Q000175:diagnosis / Q000000981:diagnostic imaging; D018570:Risk Assessment / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference