Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sampleBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7017.1401 (Published 25 November 1995) Cite this as: BMJ 1995;311:1401
- T S Han, PhD studenta,
- E M van Leer, epidemiologistb,
- J C Seidell, head of departmentb,
- M E J Lean, Rank professor of human nutritiona
- aDepartment of Human Nutrition, University of Glasgow, Royal Infirmary, Queen Elizabeth Building, Glasgow G31 2ER
- bDepartment of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, Netherlands
- aCorrespondence to: Professor Lean.
- Accepted 5 October 1995
Objective: To determine the frequency of cardiovascular risk factors in people categorised by previously defined “action g126 levels” of waist circumference.
Design: Prevalence study in a random population sample.
Subjects: 2183 men and 2698 women aged 20-59 years selected at random from the civil registry of Amsterdam and Maastricht.
Main outcome measures: Waist circumference, waist to hip ratio, body mass index (weight (kg)/height (m2)), total plasma cholesterol concentration, high density lipoprotein cholesterol concentration, blood pressure, age, and lifestyle.
Results: A waist circumference exceeding 94 cm in men and 80 cm in women correctly identified subjects with body mass index of >/=25 and waist to hip ratios >/=0.95 in men and >/=0.80 in women with a sensitivity and specificity of >/=96%. Men and women with at least one cardiovascular risk factor (total cholesterol >/=6.5 mmol/l, high density lipoprotein cholesterol </=0.9 mmol/l, systolic blood pressure >/=160 mm Hg, diastolic blood pressure >/=95 mm Hg) were identified with sensitivities of 57% and 67% and specificities of 72% and 62% respectively. Compared with those with waist measurements below action levels, age and lifestyle adjusted odds ratios for having at least one risk factor were 2.2 (95% confidence interval 1.8 to 2.8) in men with a waist measurement of 94-102 cm and 1.6 (1.3 to 2.1) in women with a waist measurement of 80-88 cm. In men and women with larger waist measurements these age and lifestyle adjusted odds ratios were 4.6 (3.5 to 6.0) and 2.6 (2.0 to 3.2) respectively.
Conclusions: Larger waist circumference identifies people at increased cardiovascular risks.
Funding Department of Human Nutrition discretionary funds, University of Glasgow (TSH); Netherlands Ministry of Health, Welfare, and Sport (EMVL and JCS); Rank Foundation and Rank prize funds (MEJL).
Conflict of interest None.
- Accepted 5 October 1995