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Large waist circumference associated, independent of BMI, with increased levels of inflammatory markers, type 2 diabetes, insulin resistance, hyperlipidemia and coronary artery disease.
Strongly correlated with visceral adipose tissue.
Visceral adipose tissue more pathogenic than subcutaneous fat deposits.
Associated with higher mortality.
Threshold for abdominal obesity is greater than 88 cm for women and greater than 102 cm for men (NIH).
More than 50% of men and 70% of women in the US ages 50-79 exceed abdominal obesity (Li C).
Waist circumference and waste-hip ratio are associated with cardiovascular disease and premature death independent of BMI.
The waist to hip ratio may be a more useful predictor of mortality than body mass index.
Patients with normal BMI and elevated waist circumference or waste-hip ratio are at the highest risk of death demonstrates the importance of combining BMI and central obesity category.
An association between waist circumference and mortality among 48500 men and 56343 women, 50 years or older in the Cancer Prevention Study II Nutrition Cohort revealed that very high levels of waist circumference was associated with a 2 fold higher risk of mortality (Jacobs EJ).
Adipose tissue accumulated in non truncal areas are relatively benign in comparison with adipose tissue in abdominal depots.
Prevalence of abdominal adiposity among women and overweight men has increased, irrespective of BMI categories.
Sagittal abdominal diameter (SAD) estimates intraabdominal adipose tissue better than waist circumference.
SAD also known as abdominal height.
SAD/height ratio serves to identify cardio metabolic risk.
Intra-abdominal adipose tissue reflects dyslipidemic hormonal inflammatory features that constitute dysfunctional adiposity.
Subcutaneous adipose tissue serves as a metabolic sink doing periods of caloric excess and is the source of necessary fuels when they are required.