OBJECTIVE: To evaluate the merit of body mass index (BMI), % body fat, waist circumference and waist-to-hip ratio as predictors of abdominal visceral fat (AVF) level.
DESIGN: Cross-sectional measurements obtained from 458 female and 331 male subjects of French Canadian descent with an age range from 18–72 y.
MEASUREMENTS: AVF level was assessed by computed tomography. BMI was calculated as weight (in kg) divided by stature2 (in m), body density was derived from underwater weighing and % body fat was computed from the estimate of body density with the Siri equation. Waist-to-hip ratio was calculated as waist circumference divided by hip circumference. Receiver operating characteristic (ROC) curves were used to identify the optimal cut-off points.
RESULTS: In younger women (<40 y, n=258), waist-to-hip ratio was the poorest predictor of AVF level with areas under the ROC curves (Az) ranging from 0.684–0.716, sensitivity (Sen) from 63.3–68.8% and specificity (Spe) from 64.0–67.5%, whereas the Az, Sen and Spe for other predictors ranged from 0.924–0.983, 87.0–96.8, and 83.4–92.7, respectively. The same trend was observed in older (≥40 y, n=200) women, although differences between waist-to-hip ratio and other predictors were less pronounced. In older men, waist circumference was the best overall predictor (Az from 0.88–0.92), whereas BMI showed the lowest Az values (0.831–0.875, P≤0.001 vs waist circumference). In younger men, BMI had the smallest Az (P<0.007 vs others) with the lowest AVF cut-off point (100 cm2). However, with higher AVF cut-offs the differences were not significant.
CONCLUSION: Waist circumference is the best overall predictor of abdominal visceral obesity, whereas in women waist-to-hip ratio is a poor indicator of AVF and its use as a surrogate measure of visceral fat should be avoided.
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Rankinen, T., Kim, S., Pérusse, L. et al. The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis. Int J Obes 23, 801–809 (1999). https://doi.org/10.1038/sj.ijo.0800929
- percent body fat
- waist girth
- ROC curves
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