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waist circumference

Indications: - assessment of cardiovascular risk in overwight & obese patients Contraindications: - unnecessary in patients with BMI >= 35 Reference interval: - current guidelines propose cutoffs for waist circumference of 40 inches (102 cm) in men & 35 inches (88 cm) in women. Procedure: - measured at the level of the iliac crest Clinical significance: - waist circumference is an independent predictor of mortality & cardiovascular mortality. [1,2] - indicator of risk for metabolic syndrome [4] - cost-effective cardiovascular risk stratification tool [4] - increased BMI, waist circumference or waist-to-hip ratio equally predictive of risk [3] - central obesity is associated with an increased risk of diabetes mellitus type 2, dysplipidemia, hypertension, & cardiovascular disease in overweight & obese patients [4] - mortality risk increases linearly with waist circumferences > 90 cm for men & 80 cm for women [6] Notes: - should be a vital sign [5]

Related

body mass index (BMI) waist-to-hip ratio

General

circumference

References

  1. Pischon T et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008 Nov 13; 359:2105.
  2. Jacobs EJ et al. Waist circumference and all-cause mortality in a large US cohort. Arch Intern Med 2010 Aug 9/23; 170:1293 PMID: 20696950
  3. The Emerging Risk Factors Collaboration. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: Collaborative analysis of 58 prospective studies. Lancet 2011 Mar 26; 377:1085. PMID: 21397319
  4. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18 American College of Physicians, Philadelphia 2012, 2015, 2018
  5. Reuters Staff Waist Circumference Should Be a Routine Vital Sign: Consensus Statement Medscape - Feb 04, 2020 https://www.medscape.com/viewarticle/924770
  6. Jayedi A et al. Central fatness and risk of all cause mortality: Systematic review and dose-response meta-analysis of 72 prospective cohort studies. BMJ 2020 Sep 23; 370:m3324. PMID: 32967840 PMCID: PMC7509947 Free PMC article https://www.bmj.com/content/370/bmj.m3324