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Waist circumference predicts metabolic cardiovascular risk in postmenopausal Chinese women

Hwu, Chii-Min MD1,2,5; Fuh, Jong-Ling MD3,5; Hsiao, Chin-Fu PhD6; Wang, Shuu-Jiun MD3,5; Lu, Shiang-Ru MD3,5; Wei, Mei-Chih BSc4; Kao, Wei-Yi4; Hsiao, Li-Chuan BPharm2; Ho, Low-Tone MD2,4,5


Objective The purpose of the study is to compare the differences in metabolic cardiovascular risk factors among postmenopausal Chinese women with or without abdominal obesity.

Design The study is a cross-sectional, population-based, comparative cohort study. Each participant received anthropometric measurements and a 75-g oral glucose tolerance test after an overnight fast. The homeostasis model assessment for insulin resistance and the insulin sensitivity index, ISI0,120, were used as measures of insulin resistance. A “metabolic cardiovascular risk score” was calculated from fasting insulin, glucose, lipids, and blood pressure. General linear models (GLM) were fit to examine the relation of waist circumference (WC) to insulin resistance and metabolic risk scores.

Results According to the International Obesity Task Force obesity criteria for Asians, 57 women had abdominal obesity (WC ≥ 80 cm), and 58 had WCs less than 80 cm. The two groups were comparable in demographic variables and body mass index (BMI). The women with larger WCs were more insulin-resistant than their counterparts. The metabolic risk scores were significantly higher in women with abdominal obesity than in those without it. The results from the GLM showed that WC was an independent predictor of insulin resistance and metabolic risk scores after controlling for demographic variables (0.06- and 0.29-unit increases in homeostasis model assessment for insulin resistance and metabolic risk scores per 1 cm change in WC). Moreover, BMI neither correlated with metabolic risk scores nor affected the WC effects on insulin resistance and metabolic risk scores in the GLM.

Conclusions Postmenopausal Chinese women with adbominal obesity may carry higher metabolic cardiovascular risk than those without it. It is WC, not BMI, that predicts metabolic cardiovascular risk factors in these women.

From the Sections of 1General Medicine and 2Endocrinology and Metabolism, Department of Medicine, 3The Neurological Institute, and the 4Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; 5Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; and the 6Division of Biostatistics and Bioinformatics, National Health Research Institute, Taipei, Taiwan.

Received April 17, 2002; revised and accepted July 2, 2002.

The work was supported by grants from the National Health Research Institute ROC (NHRI-GT-EX89-P923C, NHRI-GT-EX90-8923PC, and NHRI-EX91-8923PC) and the Taipei Veterans General Hospital (VAC-89-404-4).

Address reprint requests to Chii-Min Hwu, MD, Section of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan. E-mail:

©2003The North American Menopause Society