Original Article

International Journal of Obesity (2006) 30, 106–111. doi:10.1038/sj.ijo.0803111; published online 27 September 2005

Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity

A Misra1, N K Vikram1, R Gupta2, R M Pandey3, J S Wasir1 and V P Gupta4

  1. 1Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Medicine, Monilek Hospital and Research Centre, Jaipur, India
  3. 3Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
  4. 4Department of Statistics, University of Rajasthan, Jaipur, India

Correspondence: Professor A Misra, Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. E-mail: anoopmisra@metabolicresearchindia.com

Received 28 November 2004; Revised 7 July 2005; Accepted 20 July 2005; Published online 27 September 2005.

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Abstract

Objective:

 

To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians.

Design:

 

Analysis of data from multisite cross-sectional epidemiological studies in north India.

Subjects:

 

In all, 2050 adult subjects >18 years of age (883 male and 1167 female subjects).

Measurements:

 

Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol.

Results:

 

In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI >21 kg/m2. WC levels of greater than or equal to90 and greater than or equal to80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of greater than or equal to25 kg/m2. The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study.

Conclusion:

 

We propose the following WC action levels for adult Asian Indians: action level 1: men, greater than or equal to78 cm, women, greater than or equal to72 cm; and action level 2: men, greater than or equal to90 cm, women, greater than or equal to80 cm.

Keywords:

waist circumference, abdominal obesity, action levels, diabetes, Asian Indians

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