Relationship of abdominal obesity with cardiovascular disease, diabetes and hyperlipidaemia in Spain.

OBJECTIVES: To evaluate the relevance of obesity and abdominal obesity in the prevalence of cardiovascular disease (CVD), diabetes mellitus, hyperlipidaemia and hypertension in primary care patients and to ascertain whether waist circumference (WC) measurement should be included in routine clinical practice in addition to body mass index (BMI). METHODS: As part of the IDEA study, primary care physicians from Spain recruited patients aged 18-80 years. WC and BMI and the presence of CVD, diabetes mellitus, hyperlipidaemia and hypertension were recorded. Finally, 17 980 were analysed. An age-related increase in adiposity was observed. Overall 33% were obese by BMI, and 51% of subjects presented abdominal obesity by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) (WC > 102 cm for men and > 88 cm for women). Although there was a correlation between BMI and WC, they presented different distribution patterns. Women, but not men, with a high level of education, professional activity and smoking were associated with a lower WC. Abdominal obesity was significantly associated with CVD. Some subjects with abdominal obesity but lean by BMI, showed an increased prevalence of CVD and diabetes. Furthermore, abdominal obesity was strongly associated with dyslipidaemia and hypertension. CONCLUSIONS: Half of the primary care patients studied showed abdominal obesity as measured by WC, whereas one-third was obese by BMI. Abdominal obesity was strongly associated with CVD and diabetes, even in patients lean by BMI. WC should be included in the routine clinical practice in addition to BMI.

[Prediction of glucose and insulin resistance disorders by using anthropometric parameters of central adiposity: PRED-IR study]. / Predicción de la glucemia basal alterada y resistencia a la insulina mediante el uso de medidas antropométricas de adiposidad central: estudio PRED-IR.

BACKGROUND AND OBJECTIVE: To assess the predictive value of some anthropometric parameters of central adiposity for the diagnosis of hyperglycemia and insulin resistance (IR) in the Spanish population. PATIENTS AND METHOD: Multicenter, cross-sectional study carried out in patients visited in primary care and in specialist clinics, of both sexes, between 18 and 79 years of age. IR was estimated in a subsample of patients by the Homeostasis Model Assessment (HOMA-IR). Patients with diagnosis of diabetes were excluded from the study. RESULTS: A total of 3,638 patients were evaluated, 690 out of these participated in the IR substudy. Waist circumference (WC) was the parameter with a better correlation with hyperglycemia and with IR (r = 0.29 and 0.38; p < 0.001). Each increase of 15 cm in the WC was associated with an increase of the risk hyperglycemia and IR (65% and 123%, respectively). The cut-off points that better discriminated men and women, with and without IR, were 105 and 91 cm, with a sensitivity of 62% (95% confidence interval [CI], 46-77%) and 71% (95% CI, 54-85%), and a specificity of 72% (95% CI, 66-78%) and 68 (95% CI, 63-73%), respectively. CONCLUSIONS: WC is a useful anthropometric measure for the detection of hyperglycemia and IR, and the optimal cut-off points for the Spanish population from which IR could be detected are 105 cm for men and 91 for women.