Waist circumference, waist–hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults
Article first published online: 27 NOV 2003
Journal of Internal Medicine
Volume 254, Issue 6, pages 555–563, December 2003
How to Cite
Dalton, M., Cameron, A. J., Zimmet, P. Z., Shaw, J. E., Jolley, D., Dunstan, D. W., Welborn, T. A. and On behalf of the AusDiab steering committee (2003), Waist circumference, waist–hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. Journal of Internal Medicine, 254: 555–563. doi: 10.1111/j.1365-2796.2003.01229.x
- Issue published online: 27 NOV 2003
- Article first published online: 27 NOV 2003
- Received 16 April 2003; revision received 19 June 2003; accepted 3 July 2003.
- body mass index;
- body size;
- waist circumference;
- waist–hip ratio
Objectives. To compare body mass index (BMI), waist circumference and waist–hip ratio (WHR) as indices of obesity and assess the respective associations with type 2 diabetes, hypertension and dyslipidaemia.
Design and setting. A national sample of 11 247 Australians aged ≥25 years was examined in 2000 in a cross-sectional survey.
Main outcome measures. The examination included a fasting blood sample, standard 2-h 75-g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity.
Results. The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior.
Conclusions. Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age-adjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.