Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Which method should be used to determine the obesity, in patients with coronary artery disease? (body mass index, waist circumference or waist–hip ratio)

Abstract

OBJECTIVE: To determine body mass index (BMI), waist circumference and waist-hip ratio (WHR) in cases with angiographically established coronary artery disease (CAD) and to compare the obesity degrees established according to the ranges determined by the International Guidelines Committees for BMI, waist circumference and WHR.

DESIGN: Cross-sectional, observational study.

SUBJECTS: A total of 617 consecutive cases (516 males, mean age: 57.2±10.8 y) with CAD who underwent their first coronary angiography between January 2000 and May 2000.

MEASUREMENTS:Before coronary angiography, their heights, weights, waist and hip circumferences were measured. Waist circumferences, BMI and WHRs were compared both as a whole and also within stratified groups as for sexes and age groups categorized in decades above 40 y of age.

RESULTS: Overweight cases comprised approximately half of the patients in both sexes. In males, the percentages of obese cases with respect to BMIs were 15%, while males with action level 2 waist circumferences were detected to be 20%. Obese male patients whose WHRs were ≥0.95 were found to be 51%. In female cases, corresponding percentages of obesity were estimated to be 32, 72 and 86%, respectively.

CONCLUSION: In the same patient groups, the prevalence of obesity, defined by BMI, waist circumference and WHR, could vary three-fold. Thus, some patients may not display a diagnosis of obesity. To prevent this possibility the waist circumference is an easy method, which reflects central obesity more accurately.

This is a preview of subscription content, access via your institution

Access options

Buy this article

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Hubert HB, Feinleib M, McNamara PM, Castelli WP . Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968–977.

    Article  CAS  Google Scholar 

  2. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH . A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990; 322: 882–889.

    Article  CAS  Google Scholar 

  3. Rosengren A, Wedel H, Wilhelmsen L . Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality. A prospective population study. Eur Heart J 1999; 20: 269–277.

    Article  CAS  Google Scholar 

  4. Rimm EB, Stampfer MJ, Giovannucci E, Ascherio A, Spiegelman D, Colditz GA, Willett WC . Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol 1995; 141: 1117–1127.

    Article  CAS  Google Scholar 

  5. Prineas RJ, Folsom AR, Kaye SA . Central adiposity and increased risk of coronary artery disease mortality in older women. Ann Epidemiol 1993; 3: 35–41.

    Article  CAS  Google Scholar 

  6. Folsom AR, Kaye SA, Sellers TA, Hong CP, Cerhan JR, Potter JD, Prineas RJ . Body fat distribution and 5-year risk of death in older women. JAMA 1993; 269: 483–487.

    Article  CAS  Google Scholar 

  7. Ferland M, Despres JP, Tremblay A, Pinault S, Nadeau A, Moorjani S, Lupien PJ, Theriault G, Bouchard C . Assessment of adipose tissue distribution by computed axial tomography in obese women: association with body density and anthropometric measurements. Br J Nutr 1989; 61: 139–148.

    Article  CAS  Google Scholar 

  8. Rankinen T, Kim SY, Perusse L, Despres JP, Bouchard C . The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis. Int J Obes Relat Metab Disord 1999; 23: 801–809.

    Article  CAS  Google Scholar 

  9. Despres JP, Prud'homme D, Pouliot MC, Tremblay A, Bouchard C . Estimation of deep abdominal adipose-tissue accumulation from simple anthropometric measurements in men. Am J Clin Nutr 1991; 54: 471–477.

    Article  CAS  Google Scholar 

  10. Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ . Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994; 73: 460–468.

    Article  CAS  Google Scholar 

  11. Physical status: The use and interpretation of anthropometry. Report of WHO Expert Commitee. WHO technical report series 854. World Health Organisation: Geneva, 1995.

  12. Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K . Prevention of coronary heart disease in clinical practice. Recommendations of the Second Joint Task Force of European and other Societies on coronary prevention. Eur Heart J 1998; 19: 1434–1503.

    Article  Google Scholar 

  13. Han TS, van Leer EM, Seidell JC, Lean ME . Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401–1405.

    Article  CAS  Google Scholar 

  14. Gutierrez-Fisac JL, Banegas Banegas JR, Artalejo FR, Regidor E . Increasing prevalence of overweight and obesity among Spanish adults, 1987–1997. Int J Obes Relat Metab Disord 2000; 24: 1677–1682.

    Article  CAS  Google Scholar 

  15. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998; 22: 39–47.

    Article  CAS  Google Scholar 

  16. Wilding J . Science, medicine, and the future. Obesity treatment. BMJ 1997; 315: 997–1000.

    Article  CAS  Google Scholar 

  17. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP . The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999; 282: 1519–1522.

    Article  CAS  Google Scholar 

  18. Spataro JA, Dyer AR, Stamler J, Shekelle RB, Greenlund K, Garside D . Measures of adiposity and coronary heart disease mortality in the Chicago Western Electric Company Study. J Clin Epidemiol 1996; 49: 849–857.

    Article  CAS  Google Scholar 

  19. Jousilahti P, Toumilehto J, Vartiainen E, Korhonen HJ, Pitkaniemi J, Nissinen A, Puska P . Importance of risk factor clustering in coronary heart disease mortality and incidence in eastern Finland. J Cardiovasc Risk 1995; 2: 63–70.

    Article  CAS  Google Scholar 

  20. Dyer A, Stamler J, Berkson DM, Lindberg HA . Relationship of relative weight and body mass index to 14-year mortality in the Peoples Gas Company Study. J Chronic Dis 1975; 28: 109–123

    Article  CAS  Google Scholar 

  21. Berchtold P, Jorgens V, Finke C, Berger M . Epidemiology of obesity and hypertension. Int J Obesity 1981; 5(Suppl 1): 1–7.

    CAS  Google Scholar 

  22. Denke MA, Sempos CT, Grundy SM . Excess body weight. An underrecognized contributor to high blood cholesterol levels in white American men. Arch Intern Med 1993; 153: 1093–1103.

    Article  CAS  Google Scholar 

  23. Garrison RJ, Wilson PW, Castelli WP, Feinleib M, Kannel WB, McNamara PM . Obesity and lipoprotein cholesterol in the Framingham offspring study. Metabolism 1980; 29: 1053–1060.

    Article  CAS  Google Scholar 

  24. Hartz AJ, Rupley DC Jr, Kalkhoff RD, Rimm AA . Relationship of obesity to diabetes: influence of obesity level and body fat distribution. Prev Med 1983; 12: 351–357.

    Article  CAS  Google Scholar 

  25. Montaye M, De Bacquer D, De Backer G, Amouyel P . Overweight and obesity: a major challenge for coronary heart disease secondary prevention in clinical practice in Europe. Eur Heart J 2000; 21: 808–813.

    Article  CAS  Google Scholar 

  26. EUROASPIRE: A European Society of Cardiology survey of secondary prevention of coronary heart disease: principal results. EUROASPIRE Study Group. European Action on Secondary Prevention through Intervention to Reduce Events. Eur Heart J 1997; 18: 1569–1582.

  27. Bowker TJ, Clayton TC, Ingham J, McLennan NR, Hobson HL, Pyke SD, Schofield B, Wood DA . A British Cardiac Society survey of the potential for the secondary prevention of coronary disease: ASPIRE (Action on Secondary Prevention through Intervention to Reduce Events). Heart 1996; 75: 334–342.

    Article  CAS  Google Scholar 

  28. Katzel LI, Bleecker ER, Colman EG, Rogus EM, Sorkin JD, Goldberg AP . Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men. A randomized controlled trial. JAMA 1995; 274: 1915–1921.

    Article  CAS  Google Scholar 

  29. Carey VJ, Walters EE, Colditz GA, Solomon CG, Willett WC, Rosner BA, Speizer FE, Manson JE . Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses' Health Study. Am J Epidemiol 1997; 145: 614–619.

    Article  CAS  Google Scholar 

  30. Folsom AR, Prineas RJ, Kaye SA, Munger RG . Incidence of hypertension and stroke in relation to body fat distribution and other risk factors in older women. Stroke 1990; 21: 701–706.

    Article  CAS  Google Scholar 

  31. Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C . Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis 1990; 10: 497–511.

    Article  CAS  Google Scholar 

  32. Sansoy V . Türk erişkinlerinde beden kitle indeksi ve bel kalça oranlarï. Onat A, Şurdum avcï G, Soydan, Koylan N, Sansoy V Tokgözoğlu L. Türk Erişkinlerinde Kalp Sağlïğïnïn Dünü ve Bugünü: TEKHARF çalïşmasïnïn sağladïğï üç boyutlu harita. Kibele Tanïtïm: Istanbul; 1996; pp 91–100.

  33. Freedman DS, Jacobsen SJ, Barboriak JJ, Sobocinski KA, Anderson AJ, Kissebah AH, Sasse EA, Gruchow HW . Body fat distribution and male/female differences in lipids and lipoproteins. Circulation 1990; 81: 1498–1506.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Corresponding author

Correspondence to K Sönmez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sönmez, K., Akçakoyun, M., Akçay, A. et al. Which method should be used to determine the obesity, in patients with coronary artery disease? (body mass index, waist circumference or waist–hip ratio). Int J Obes 27, 341–346 (2003). https://doi.org/10.1038/sj.ijo.0802238

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802238

Keywords

This article is cited by

Search

Quick links