Where to Draw the Line for Abdominal Obesity: Evidence from International Data

• Activity Number: 555
• Type: Topic Contributed
• Date/Time: Thursday, August 6, 2009 : 8:30 AM to 10:20 AM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Mark Woodward*+
• Companies: Mount Sinai School of Medicine
• Keywords: Obesity ; Diabetes ; Body mass index ; Waist circumference ; Waist-to-hip ratio ; ROC curve

Abstract

Data from 155,122 people (86% Asian; 52% female) from 10 countries (18 studies) in the Asia-Pacific region were compiled. The prevalence of diabetes was higher, per unit of excess weight, among Asians than Whites. Discrimination was best for waist circumference (WC). Cut points for optimal discrimination of diabetes were lower in Asians compared with Whites. The optimal thresholds for Asian men were: BMI 23.7 kg/m2, WC 85 cm, and waist:hip ratio 0.90, versus 27.7, 99, and 0.94 in White men. For Asian women, the corresponding values were 24.5, 80, and 0.80, and in White women, 27.9, 85, and 0.85. These cut points optimized sensitivity and specificity such that both values nearly always exceeded 60% in all groups. How meaningful such thresholds are when obesity is linked to several diseases, such as coronary heart disease, in a log-linear relationship remains to be seen.