Abdominal obesity and the “hypertriglyceridaemic waist” phenotype

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7288.687 (Published 24 March 2001) Cite this as: BMJ 2001;322:687

It's probably not yet time to implement screening

  1. Paul Little (P.Little@soton.ac.uk), MRC clinician scientist,
  2. Christopher D Byrne, professor of endocrinology and metabolism
  1. Primary Medical Care group, Community Clinical Sciences Division, Southampton University, Aldermoor Health Centre, Southampton SO16 5ST
  2. Southampton University Hospitals Trust, Southampton SO16 6YD

    Clinical review p 716

    Generalised obesity, measured by body mass index (weight (kg)/(height (m)2)), is one of the major causes of ill health in western society. However, abdominal obesity—which is closely associated with intra-abdominal fat and measured either by waist circumference or waist:hip ratio—predicts subsequent coronary artery disease better than body mass index.1 Furthermore, obesity, particularly abdominal obesity, is associated with insulin resistance, and predicts the development of type 2 diabetes. 2 3 On p 716 Després et al argue that waist circumference should be routinely measured in primary care and used to identify people with abdominal obesity, on whom efforts to reduce obesity should be targeted.4

    High waist measurement may be useful for screening since (a) height contributes little to the variance, (b) it accurately predicts obesity and high waist:hip ratio,5 and (c) it predicts traditional coronary artery disease risk factors.5 High waist and fasting triglyceride measurements—the hypertriglyceridaemic waist—is a marker for the “metabolic syndrome,” which is associated with the traditional risk factors of hypertension, hyperglycaemia, low high density lipoprotein (HDL) cholesterol and the non-traditional risk factors of insulin resistance, hyperinsulinaemia, raised …

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