Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity

Abstract

Objective: To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians. Design: Analysis of data from multisite cross-sectional epidemiological studies in north India. Subjects: In all, 2050 adult subjects 418 years of age (883 male and 1167 female subjects). Measurements: Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol. Results: In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI 421 kg/m 2 . WC levels of X90 and X80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of X25 kg/m 2 . The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study. Conclusion: We propose the following WC action levels for adult Asian Indians: action level 1: men, X78 cm, women, X72 cm; and action level 2: men, X90 cm, women, X80 cm.

Vitamin D status and metabolic syndrome in Asian Indians

“…2,10 Subjects were classified as having MS according to the National Cholesterol Education Program/Adult Treatment Panel III definition (blood pressure of X130/85 mm Hg; triglycerides X1.7 mmol l À1 (X150 mg per 100 ml); HDL cholesterol o1.0 mmol l À1 (o40 mg per 100 ml) and o1.3 mmol l À1 (o50 mg per 100 ml) in men and women, respectively; and fasting blood glucose X6.1 mmol l À1 (X110 mg per 100 ml) with modified waist circumference cut off values (males 490 cm, females 480 cm) appropriate for Indians. 11,12 Presence of three or more parameters was considered for defining MS-positive subjects. Obesity was defined as BMI X25 kg m À2 .…”

Medida da cintura e razão cintura/quadril e identificação de situações de risco cardiovascular: estudo multicêntrico em pacientes com diabetes melito tipo 2

“…Outros autores consideram que a medida da cintura é melhor preditor de obesidade, dislipidemia e risco cardiovascular (4,(12)(13)(14). Deve também ser considerado que o padrão de distribuição da gordura pode variar de acordo com os grupos étnicos, e tem sido recomendado que essas medidas sejam padronizadas para as diversas etnias (15)(16)(17)(18)(19)(20)(21). Ainda, os pontos de corte para a medida da cintura considerados como de risco cardiovascular, e que são utilizados no diagnóstico da sín-drome metabólica, variam de acordo com as recomendações de diferentes sociedades (21,22).…”

Sensitivity and specificity of waist circumference as a single screening tool for assessment of overweight and obesity

“…But in several studies in India, researcher have suggested a more stringent cut-off for both BMI and WC, as Indians are more prone to cardiovascular risk factors and metabolic syndrome. 15,19 In a study by Misra et al, it was found that, though in male subjects, a WC cutoff point of 90 cm (sensitivity 90.1%, specificity 83.6%), and in female subjects, a cutoff point of 80cm (sensitivity 92.3%, specificity 76.8%) was good enough for identifying those with a BMI ≥25 kg/m 2 but it had showed a lower sensitivity (49.7% in male and 50.3% in female) in identifying those with at least one cardiovascular risk factor. 19 In the same study, it was shown, for identifying those with BMI ≥23 kg/m 2 , the current WC cut-off had sensitivity 78.8% & specificity 93.2% for males and sensitivity 85.2% & specificity 84.9% for females.…”

“…15,19 In a study by Misra et al, it was found that, though in male subjects, a WC cutoff point of 90 cm (sensitivity 90.1%, specificity 83.6%), and in female subjects, a cutoff point of 80cm (sensitivity 92.3%, specificity 76.8%) was good enough for identifying those with a BMI ≥25 kg/m 2 but it had showed a lower sensitivity (49.7% in male and 50.3% in female) in identifying those with at least one cardiovascular risk factor. 19 In the same study, it was shown, for identifying those with BMI ≥23 kg/m 2 , the current WC cut-off had sensitivity 78.8% & specificity 93.2% for males and sensitivity 85.2% & specificity 84.9% for females. 19 Midha et al in her study in Kanpur, India estimated that, the cut-offs for waist circumference for predicting hypertension were ≥83 cm for men and ≥78 cm for women.…”