Waist circumference vs body mass index for prediction of disease risk in postmenopausal women

OBJECTIVE: To test the sensitivity of waist circumference (central adiposit y) as an index of disease risk in postmenopausal women. DESIGN: Retrospective analysis of postmenopausal women tested at Washington University School Of Medicine. SUSBJECTS: A total of 323 healthy postmenopausal (66 +/- 5 y; mean +/- s.d. ) women not using any hormone replacement. MEASUREMENTS: Body composition, hyperinsulinemia (insulin area), triglyceri des and HDL-cholesterol. RESULTS: Excess waist size had a stronger association with hyperinsulinemia and hypertriglyceridemia than body mass index (BMI; kg/m(2)) in otherwise healthy, postmenopausal women. After adjusting for BMI, a strong relation e xisted between waist circumference and insulin area, HDL-cholesterol and tr iglycerides (P < 0.01). Conversely, after adjusting for waist circumference , no relation was apparent between BMI and the dependent variables of inter est. The strength of the association between waist circumference and diseas e risk became most apparent when analyses were restricted to normal-weight women (BMI 24-28 kg/m(2)). When BMI was held constant, hyperinsulinemia and triglyceridemia increased dose-dependently with changes in waist size. CONCLUSION: Waist circumference, an easily obtained index of central adipos ity, is a more sensitive measure of relative disease risk than is BMI in mi ddle-aged and older women, particularly in normal-weight individuals.