title: Reappraisal of waist circumference cutoff value according to general obesity.
abstract: BACKGROUND
  Current criterion of waist circumference (WC) for abdominal obesity is not enough to demonstrate characteristics of obese and non-obese populations defined by BMI. The aim of this study was to redefine the cutoff values of WC according to general obesity (BMI ≥ 25 kg/m(2)).
  
  
  METHODS
  The receiver operating characteristic curve analysis was performed to determine cutoff values of WC for predicting atherosclerosis according to BMI in 1,063 non-diabetic subjects. To validate this new criterion, diabetic patients (n = 3,690) were divided into three groups based on the current (WC of 90/80 cm for men/women) and new cutoff values of WC: 1) group with WC below the lowest value of two criteria; 2) intermediate group defined as having a WC between them; and 3) group with WC more than the highest value of them.
  
  
  RESULTS
  The new cutoff values of WC for predicting atherosclerosis in non-diabetic subjects were 84/76 cm for non-obese men/women, and 93/87 cm for obese men/women, respectively. Of non-obese diabetic patients, the intermediate group (WC 84 ~ 90/76 ~ 80 cm for men/women) was more insulin resistant and showed elevated odds ratio (OR) for having 2 or more metabolic risk factors compared to group with WC below 84/76 cm for men/women [OR 2.48 (95 % CI 1.89-3.25) in men, 2.01 (95% CI 1.45-2.78) in women]. In contrast, among obese diabetic patients, insulin resistance and the likelihood of having 2 or more metabolic risk factors were not different from the intermediate group (WC 90 ~ 93/80 ~ 87 cm for men/women) and group with WC below 90/80 cm for men/women.
  
  
  CONCLUSIONS
  The current universal cutoff values of WC may under- or over-estimate the metabolic risks of intermediate groups. Therefore, the WC criteria for abdominal obesity should be applied differently depending on the BMI.
authors.affiliation: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Republic of Korea.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Oh
authors.affiliation: Huh's Diabetes Center and the 21th Century Diabetes and Vascular Research Institute, Seoul, Republic of Korea.
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Huh's Diabetes Center and the 21th Century Diabetes and Vascular Research Institute, Seoul, Republic of Korea.
authors.forename: Byung Wook
authors.initials: BW
authors.lastname: Huh
authors.affiliation: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Jig
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: Yong-Wook
authors.initials: YW
authors.lastname: Cho
authors.affiliation: Huh's Diabetes Center and the 21th Century Diabetes and Vascular Research Institute, Seoul, Republic of Korea.
authors.forename: Kap-Bum
authors.initials: KB
authors.lastname: Huh
keywords: Abdominal obesity; Obesity; Waist circumference