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Critical value for the index of body fat distribution based on waist and hip circumferences and stature in obese girls

International Journal of Obesity volume 24, pages 1026–1031 (2000)Cite this article

Abstract

OBJECTIVE: To determine the critical value for the standard deviation score (SDS) of waist–hip ratio (WHR)/height (Ht), as an age‐adjusted measure of body fat distribution, in relation to occurrence of biochemical complications in obese girls.

DESIGN: Cross‐sectional, clinical study. The (WHR/Ht)‐SDS was calculated as described previously. Obese girls were classified into two groups according to the occurrence of abnormal values in either serum triglyceride, alanine aminotransferase or insulin level. The criteria for obesity were subjected to the receiver operating characteristic (ROC) analysis.

SUBJECTS: One‐hundred and twenty‐four outpatient Japanese obese girls, ranging in age from 9 to 15 y.

MEASUREMENTS: Height, body weight, waist girth and hip girth as anthropometric measures. Percentage overweight, waist girth, WHR and (WHR/Ht)‐SDS as criteria for obesity. Clinical laboratory analysis for fasting blood samples of obese children.

RESULTS: Fifty‐nine girls were classified into the no complication group, and 65 girls into the complication group. Those with complications were older, more obese, and their waist girth and WHR were larger, than the girls without complications. The (WHR/Ht)‐SDS was >2‐fold higher and lipoprotein profile was more atherogenic in the complication group than in the no complication group. Among the four criteria of obesity, (WHR/Ht)‐SDS gave the ROC curve skewed furthest into the top left corner of the diagram. Both sensitivity and specificity for (WHR/Ht)‐SDS were >80% at the critical value of 2.00. The sensitivity for waist girth was as high as that for specificity for the rest of the criteria were <80%.

CONCLUSION: Only (WHR/Ht)‐SDS showed high enough sensitivity and specificity to predict metabolic derangement in the present obese girls. (WHR/Ht)‐SDS can serve as the diagnostic criterion that classifies obesity in Japanese adolescent girls into two types.

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References

  1. Asayama K, Hayashibe H, Dobashi K, Uchida N, Kawada Y, Nakazawa S . Relationships between biochemical abnormalities and anthropometric indices of overweight, adiposity and body fat distribution in Japanese elementary school children Int J Obes Relat Metab Disord 1995 19: 253–259.

    CAS  PubMed  Google Scholar 

  2. Krotkiewski M, Börntorp P, Sjöström L, Smith U . Impact of obesity on metabolism in men and women: importance of regional adipose tissue distribution J Clin Invest 1983 72: 1150–1162.

    Article  CAS  Google Scholar 

  3. Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S . Contribution of intra‐abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity Metabolism 1987 36: 54–59.

    Article  CAS  Google Scholar 

  4. Pedersen SB, Børglum JD, Schmitz O, Bak JF, Sørensen NS, Richelsen B . Abdominal obesity is associated with insulin resistance and reduced glycogen synthase activity in skeletal muscle Metabolism 1993 42: 998–1005.

    Article  CAS  Google Scholar 

  5. Lemieux S, Prud'homme D, Tremblay A, Bouchard C, Despres JP . Anthropometric correlates to changes in visceral adipose tissue over 7 years in women Int J Obes Relat Metab Disord 1996 20: 618–624.

    CAS  PubMed  Google Scholar 

  6. Lemieux S, Prud'homme D, Bouchard C, Tremblay A, Despres JP . A single threshold value of waist girth identifies normal‐weight and overweight subjects with excess visceral adipose tissue Am J Clin Nutr 1996 64: 685–693.

    Article  CAS  Google Scholar 

  7. Ross R, Rissanen J, Hudson R . Sensitivity associated with the identification of visceral adipose tissue levels using waist circumference in men and women: effects of weight loss Int J Obes Relat Metab Disord 1996 20: 533–538.

    CAS  PubMed  Google Scholar 

  8. Conway JM, Chanetsa FF, Wang P . Intraabdominal adipose tissue and anthropometric surrogates in African American women with upper‐ and lower‐body obesity Am J Clin Nutr 1997 66: 1345–1351.

    Article  CAS  Google Scholar 

  9. van der Kooy K, Leenen R, Seidell JC, Deurenberg P, Visser M . Abdominal diameter as indicators of visceral fat: comparison between magnetic resonance imaging and anthropometry Br J Nutr 1993 70: 47–58.

    Article  CAS  Google Scholar 

  10. Zamboni M, Turcato E, Armellini F, Kahn HS, Zivelonghi A, Santana H, Bergamo‐Andreis IA, Bosello O . Sagittal abdominal diameter as a practical predictor of visceral fat Int J Obes Relat Metab Disord 1998 22: 655–660.

    Article  CAS  Google Scholar 

  11. Rissanen P, Hamalainen P, Vanninen E, Tenhunen‐Eskelinen M, Uusitupa M . Relationship of metabolic variables to abdominal adiposity measured by different anthropometric measurements and dual‐energy X‐ray absorptiometry in obese middle‐aged women Int J Obes Relat Metab Disord 1997 21: 367–371.

    Article  CAS  Google Scholar 

  12. Barnes VA, Treiber FA, Davis H, Kelly TR, Strong WB . Central adiposity and hemodynamic functioning at rest and during stress in adolescents Int J Obes Relat Metab Disord 1998 22: 1079–1083.

    Article  CAS  Google Scholar 

  13. Megnien JL, Denarie N, Cocaul M, Simon A, Levenson J . Predictive value of waist‐to‐hip ratio on cardiovascular risk events Int J Obes Relat Metab Disord 1999 23: 90–97.

    Article  CAS  Google Scholar 

  14. Martinez E, Devesa M, Bacallo J, Amador M . Percentiles of waist–hip ratio in Cuban scholars aged 4.5 to 20.5 years Int J Obes Relat Metab Disord 1994 18: 557–560.

    CAS  PubMed  Google Scholar 

  15. Asayama K, Hayashi K, Kawada Y, Nakane T, Uchida N, Hayashibe H, Kawasaki K, Nakazawa S . New age‐adjusted measure of body fat distribution in children and adolescents: standardization of waist hip ratio using multivariate analysis Int J Obes Relat Metab Disord 1997 21: 594–599.

    Article  CAS  Google Scholar 

  16. Asayama K, Hayashi K, Hayashibe H, Uchida N, Nakane T, Kodera K, Nakazawa S . Relationships between an index of body fat distribution based on waist and hip circumferences and stature and biochemical complications in obese children Int J Obes Relat Metab Disord 1998 22: 1209–1216.

    Article  CAS  Google Scholar 

  17. Krotkiewski M, Börntorp P, Sjöström L, Smith U . Impact of obesity on metabolism in men and women: importance of regional adipose tissue distribution J Clin Invest 1983 72: 1150–1162.

    Article  CAS  Google Scholar 

  18. Margolis CF, Sprecher DL, Simbartl LA, Campaigne BN . Male–female differences in the relationship between obesity and lipids/lipoproteins Int J Obes Relat Metab Disord 1996 20: 784–790.

    CAS  PubMed  Google Scholar 

  19. Deutsch MI, Mueller WH, Malina RM . Androgyny in fat patterning is associated with obesity in adolescents and young adults Ann Hum Biol 1985 12: 275–286.

    Article  CAS  Google Scholar 

  20. Wattigney WA, Harsha DW, Srinivasan SR, Webber LS, Berenson GS . Increasing impact of obesity on serum lipids and lipoproteins in young adults: The Bogalusa Heart Study Arch Intern Med 1991 151: 2017–2022.

    Article  CAS  Google Scholar 

  21. Friedwald WT, Levy RI, Redrickson DS . Estimation of the concentration of low density lipoprotein cholesterol without use of the preparative ultracentrifuge Clin Chem 1972 18: 499.

    Google Scholar 

  22. Hayashibe H, Asayama K, Nakane T, Uchida N, Kawada Y, Nakazawa S . Increased plasma cholesteryl ester transfer activity in obese children Atherosclerosis 1997 129: 53–58.

    Article  CAS  Google Scholar 

  23. Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Runahashi T, Matsuzawa Y . Effect of visceral fat accumulation on uric acid metabolism in male obese subjects Metabolism 1998 47: 929–933.

    Article  CAS  Google Scholar 

  24. Hashimoto M, Akishita M, Eto M, Kozaki K, Ako J, Sugimoto N, Yoshizumi M, Toba K, Ouchi Y . The impairment of flow‐mediated vasodilatation in obese men with visceral fat accumulation Int J Obes Relat Metab Disord 1998 22: 477–484.

    Article  CAS  Google Scholar 

  25. Goran MI, Nagy TR, Treuth MS, Trowbridge C, Dezenberg C, McGloin A, Gower BA . Visceral fat in White and African American prepubertal children Am J Clin Nutr 1997 65: 1703–1708.

    Article  CAS  Google Scholar 

  26. Owens S, Gutin B, Ferguson M, Allison J, Karp W, Le NA . Visceral adipose tissue and cardiovascular risk factors in obese children J Pediatr 1988 133: 41–45.

    Article  Google Scholar 

  27. Schoen RE, Thaete FL, Sankey SS, Weissfeld JL, Kuller LH . Sagittal diameter in comparison with single slice CT as a predictor of total visceral adipose tissue volume Int J Obes Relat Metab Disord 1998 22: 338–342.

    Article  CAS  Google Scholar 

  28. Goran MI, Gower BA, Treuth M, Nagy TR . Prediction of intra‐abdominal and subcutaneous abdominal adipose tissue in healthy prepubertal children Int J Obes Relat Metab Disord 1998 22: 549–558.

    Article  CAS  Google Scholar 

  29. Owens S, Litaker M, Allison J, Riggs S, Ferguson M, Gutin B . Prediction of visceral adipose tissue from simple anthropometric measurements in youths with obesity Obes Res 1999 7: 16–22.

    Article  CAS  Google Scholar 

  30. Weidner MD, Gavigan KE, Tyndall GL, Hickey MS, McCammon MR, Houmard JA . Which anthropometric indices of regional adiposity are related to the insulin resistance of aging? Int J Obes Relat Metab Disord 1995 19: 325–330.

    CAS  PubMed  Google Scholar 

  31. Ross R, Fortier L, Hudson R . Separate associations between visceral and subcutaneous adipose tissue distribution, insulin and glucose levels in obese women Diabetes Care 1996 19: 1404–1411.

    Article  CAS  Google Scholar 

  32. Vanhala MJ, Pitkajarvi TK, Kumpusalo EA, Takala JK . Obesity type and clustering of insulin resistance‐associated cardiovascular risk factors in middle‐aged men and women Int J Obes Relat Metab Disord 1998 22: 369–374.

    Article  CAS  Google Scholar 

  33. Armellini F, Robbi R, Zamboni M, Tedesco T, Castelli S, Bosello O . Resting metabolic rate, body fat distribution, and visceral fat in obese women Am J Clin Nutr 1992 56: 981–987.

    Article  CAS  Google Scholar 

  34. Macor C, Ruggeri A, Mazzonetto P, Federspil G, Cobelli C, Vettor R . Visceral adipose tissue impairs insulin secretion and insulin sensitivity but not energy expenditure in obesity Metabolism 1997 46: 123–129.

    Article  CAS  Google Scholar 

  35. Clasey JL, Bouchard C, Teates D, Riblett JE, Thorner MO, Hartman ML, Weltman A . The use of anthropometric and dual‐energy X‐ray absorptiometry (DXA) measures to estimate total abdominal and abdominal visceral fat in men and women Obes Res 1999 7: 256–264.

    Article  CAS  Google Scholar 

  36. Han TS, Seidell JC, Currall JEP, Morrison CE, Deurenberg P, Lean MEJ . The influences of height and age on waist circumference as an index of adiposity in adults Int J Obes Relat Metab Disord 1997 21: 83–89.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work is supported in part by Health Science Research Grants (Research on Children and Families) from Ministry of Health and Welfare, Japan, and a grant from the Tanita Health and Body Weight Fund.

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Authors and Affiliations

  1. Department of Pediatrics, Yamanashi Medical University, Tamahocho, Nakakomagun, Yamanashi, Japan

    K Asayama, K Dobashi, K Kodera & S Nakazawa

  2. Department of Pediatrics, Osaka Medical University, Takatsuki, Osaka, Japan

    T Oguni & Y Fukunaga

  3. Department of Basic Allied Medicine, School of Health Sciences, Faculty of Medicine, Gunma University, Maebashi, Gunma, Japan

    K Hayashi & H Tamai

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  1. K Asayama
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Correspondence to K Asayama.

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Asayama, K., Oguni, T., Hayashi, K. et al. Critical value for the index of body fat distribution based on waist and hip circumferences and stature in obese girls. Int J Obes 24, 1026–1031 (2000). https://doi.org/10.1038/sj.ijo.0801355

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