title: Finding the Best Waist Circumference Measurement Protocol in Patients With Nonalcoholic Fatty Liver Disease.
abstract: BACKGROUND
  Central fat accumulation is important in nonalcoholic fatty liver disease (NAFLD) etiology. It is unknown whether any commonly used waist circumference measurement protocol (WCmp), as a whole and central fat accumulation marker, is preferable for patients with NAFLD. The present study sought to find a preferable WCmp to be used in patients with NAFLD, based on 3-fold criteria.
  
  
  METHODS
  Body fat (BF) was assessed through dual-energy x-ray absorptiometry in 28 patients with NAFLD (19 men, 51 ± 13 years; 9 women, 47 ± 13 years). WC was measured with 4 types of WCmp: WC1, narrowest torso; WC2, just above iliac crest; WC3, middistance between iliac crest and last rib; WC4, at the umbilicus.
  
  
  RESULTS
  All WC measurements were highly correlated with central BF depots, including trunk BF (r = 0.78, r = 0.82, r = 0.82, r = 0.84 for WC1, WC2, WC3, and WC4, respectively), abdominal BF (r = 0.78, r = 0.78, r = 0.80, r = 0.72 for WC1, WC2, WC3, and WC4, respectively), and central abdominal BF (r = 0.76, r = 0.77, r = 0.78, r = 0.68 for WC1, WC2, WC3, and WC4, respectively), controlling for age, sex, and body mass index. There were no differences between the correlation coefficients obtained between all studied waist circumference measurements and each whole and central analyzed BF variable.
  
  
  CONCLUSIONS
  All studied WCmps seem suitable for use in patients with NAFLD, particularly as a central BF clinical assessment tool, though not interchangeably. Hence, biological and precision criteria alone did not sanction the superiority of any WCmp. Practical criteria may endorse WC measured at the iliac crest.
authors.affiliation: Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, Santarém, Portugal npimenta@esdrm.ipsantarem.pt.
authors.forename: Nuno M
authors.initials: NM
authors.lastname: Pimenta
authors.affiliation: Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Santa-Clara
authors.affiliation: Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, Santarém, Portugal.
authors.forename: Xavier
authors.initials: X
authors.lastname: Melo
authors.affiliation: Unidade de Nutrição e Metabolismo, IMM, Faculty of Medicine, University of Lisbon, Santa Maria Hospital, Lisbon, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Cortez-Pinto
authors.affiliation: Curry Cabral Hospital, Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Silva-Nunes
authors.affiliation: Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal.
authors.forename: Luís B
authors.initials: LB
authors.lastname: Sardinha
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000328:Adult; D000886:Anthropometry / Q000379:methods*; D050218:Body Fat Distribution / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000473:pathology*; D018709:Statistics, Nonparametric; D055105:Waist Circumference
keywords: anthropometry; body composition; body fat distribution; dual-energy x-ray absorptiometry; fatty liver; waist circumference