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Am Fam Physician. 2008;78(7):876

Background: A recent consensus statement from the American Diabetes Association, the Obesity Society, and the American Society for Nutrition questions the clinical utility of measuring waist circumference to predict the risk of diabetes and cardiovascular disease. There has been limited evidence about the predictive role of waist circumference independent of commonly measured cardiometabolic risk factors. To determine the value of waist circumference measurement in predicting diabetes and cardiovascular risk, Janiszewski and colleagues evaluated data from the most recent National Health and Nutrition Examination Survey (NHANES).

The Study: The authors reviewed NHANES data from 1999 to 2004, including approximately 3,000 men and 2,800 women. Outcome measures included waist circumference, body mass index (BMI), and height. Blood pressure, lipid panels, fasting glucose levels, and patient-reported cardiovascular events were also recorded. Waist circumference was measured at the iliac crest, and participants were stratified into three measurement categories for men (less than 35.8 in [90.9 cm], 35.8 to 40.5 in [102.9 cm], and greater than 40.5 in) and for women (less than 33.7 in [85.5 cm], 33.7 to 38.9 in [98.7 cm], and greater than 38.9 in).

Results: After controlling for age, sex, race, smoking status, cardiometabolic risk factors, and BMI, patients with waist circumferences in the medium and high categories had a twofold and fivefold increased risk of diabetes, respectively. However, waist circumference did not predict cardiovascular disease beyond the predictive value of cardiometabolic risk factors and BMI.

Conclusion: The authors conclude that measuring waist circumference in abdominally obese patients can predict the risk of diabetes independent of commonly measured risk factors. Therefore, it may be worthwhile to include the measurements in physician office visits.

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