Disclaimer: Findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference?
Article first published online: 23 OCT 2007
© 2007 The Authors. Journal compilation © 2007 International Association for the Study of Obesity
Volume 9, Issue 4, pages 312–325, July 2008
How to Cite
Ross, R., Berentzen, T., Bradshaw, A. J., Janssen, I., Kahn, H. S., Katzmarzyk, P. T., Kuk, J. L., Seidell, J. C., Snijder, M. B., Sørensen, T. I. A. and Després, J.-P. (2008), Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference?. Obesity Reviews, 9: 312–325. doi: 10.1111/j.1467-789X.2007.00411.x
- Issue published online: 23 OCT 2007
- Article first published online: 23 OCT 2007
- Received 4 July 2007; revised 9 September 2007; accepted 11 September 2007
- waist circumference
There is currently no consensus regarding the optimal protocol for measurement of waist circumference (WC), and no scientific rationale is provided for any of the WC protocols recommended by leading health authorities. A panel of experts conducted a systematic review of 120 studies (236 samples) to determine whether measurement protocol influenced the relationship of WC with morbidity of cardiovascular disease (CVD) and diabetes and with mortality from all causes and from CVD. Statistically significant associations with WC were reported for 65% (152) of the samples across all outcomes combined. Common WC protocols performed measurement at the minimal waist (33%), midpoint (26%) and umbilicus (27%). Non-significant associations were reported for 27% (64) of the samples. Most of these protocols measured WC at the midpoint (36%), umbilicus (28%) or minimal waist (25%). Significant associations were observed for 17 of the remaining 20 samples, but these were not significant when adjustment was made for covariates. For these samples, the most common WC protocols were the midpoint (35%) and umbilicus (30%). Similar patterns of association between the outcomes and all WC protocols were observed across sample size, sex, age, race and ethnicity. Our findings suggest that WC measurement protocol has no substantial influence on the association between WC, all-cause and CVD mortality, CVD and diabetes.