Waist Circumference Vs Body Mass Index for Prediction of Disease Risk in Postmenopausal Women

Objective: To test the sensitivity of waist circumference (central adiposity) as an index of disease risk in postmenopausal women.

Design: Retrospective analysis of postmenopausal women tested at Washington University School of Medicine.

Subjects: A total of 323 healthy postmenopausal (66+/-5 y; mean+/-s.d.) women not using any hormone replacement.

Measurements: Body composition, hyperinsulinemia (insulin area), triglycerides and HDL-cholesterol.

Results: Excess waist size had a stronger association with hyperinsulinemia and hypertriglyceridemia than body mass index (BMI; kg/m(2)) in otherwise healthy, postmenopausal women. After adjusting for BMI, a strong relation existed between waist circumference and insulin area, HDL-cholesterol and triglycerides (P<0.01). Conversely, after adjusting for waist circumference, no relation was apparent between BMI and the dependent variables of interest. The strength of the association between waist circumference and disease risk became most apparent when analyses were restricted to normal-weight women (BMI 24--28 kg/m(2)). When BMI was held constant, hyperinsulinemia and triglyceridemia increased dose-dependently with changes in waist size.

Conclusion: Waist circumference, an easily obtained index of central adiposity, is a more sensitive measure of relative disease risk than is BMI in middle-aged and older women, particularly in normal-weight individuals.