Full Text:   <1360>

CLC number: R58

On-line Access: 2010-09-08

Received: 2010-03-25

Revision Accepted: 2010-06-01

Crosschecked: 2010-08-11

Cited: 17

Clicked: 3896

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2010 Vol.11 No.9 P.639-646


Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women

Author(s):  Xin Ying, Zhen-ya Song, Chang-jun Zhao, Yan Jiang

Affiliation(s):  International Health Care Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China, Department of Clinical Laboratory, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):   yingxin1977@gmail.com

Key Words:  Body mass index, Waist circumference, Obesity, Cardiovascular disease, Diabetes mellitus, Women

Share this article to: More |Next Article >>>

Xin Ying, Zhen-ya Song, Chang-jun Zhao, Yan Jiang. Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women[J]. Journal of Zhejiang University Science B, 2010, 11(9): 639-646.

@article{title="Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women",
author="Xin Ying, Zhen-ya Song, Chang-jun Zhao, Yan Jiang",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women
%A Xin Ying
%A Zhen-ya Song
%A Chang-jun Zhao
%A Yan Jiang
%J Journal of Zhejiang University SCIENCE B
%V 11
%N 9
%P 639-646
%@ 1673-1581
%D 2010
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1000105

T1 - Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women
A1 - Xin Ying
A1 - Zhen-ya Song
A1 - Chang-jun Zhao
A1 - Yan Jiang
J0 - Journal of Zhejiang University Science B
VL - 11
IS - 9
SP - 639
EP - 646
%@ 1673-1581
Y1 - 2010
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1000105

Objective: To assess the associations between body mass index (BMI), waist circumference (WC), and cardiometabolic risk factors in young and middle-aged Chinese women. Methods: A total of 3011 women (1938 young women, 1073 middle-aged women), who visited our health care center for a related health checkup, were eligible for study. BMI and WC were measured. The subjects were divided into normal and overweight/obesity groups based on BMI, and normal and abdominal obesity groups based on WC. Cardiometabolic variables included triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), and blood pressure (BP). Results: The prevalence of overweight/obesity was significantly higher in middle-aged women (32.4%) than in young women (12.0%). The prevalence of abdominal obesity was also higher in middle-aged women (60.3%) than in young women (36.2%). There were significant differences in the comparison of all related cardiometabolic variables between different BMI (or WC) categories in young and middle- aged women groups, respectively. After adjustment for age, partial correlation analysis indicated that both BMI and WC were correlated significantly with all related cardiometabolic variables. After adjustment for age and WC, although the correlation coefficient r′ was attenuated, BMI was still correlated significantly with all related cardiometabolic variables in young and middle-aged women. After adjustment for age and BMI, partial correlation analysis showed that WC was correlated significantly with TG, FBG, HOMA-IR, and HDL-C in young women and significantly with TG, HOMA-IR, and HDL-C in middle-aged women. Conclusions: The prevalence of overweight/obesity and abdominal obesity was high in Chinese young and middle-aged women. BMI was a better predictor of cardiovascular disease and diabetes than WC in young and middle-aged women, and moreover, measurement of both WC and BMI may be a better predictor of cardiovascular disease and diabetes mellitus than BMI or WC alone.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1]Alberti, K.G., Zimmet, P., Shaw, J., IDF Epidemiology Task Force Consensus Group, 2005. The metabolic syndrome: a new worldwide definition. Lancet, 366(9491):1059-1062.

[2]Ardern, C.I., Katzmarzyk, P.T., Janssen, I., Ross, R., 2003. Discrimination of health risk by combined body mass index and waist circumference. Obesity, 11(1):135-142.

[3]Balkau, B., Picard, P., Vol, S., Fezeu, L., Eschwège, E., DESIR Study Group, 2007a. Consequences of change in waist circumference on cardiometabolic risk factors over 9 years: data from an epidemiological study on the insulin resistance syndrome (DESIR). Diabetes Care, 30(7):1901-1903.

[4]Balkau, B., Deanfield, J.E., Després, J.P., Bassand, J.P., Fox, K.A., Smith, S.C.Jr., Barter, P., Tan, C.E., van Gaal, L., Wittchen, H.U., et al., 2007b. International day for the evaluation of abdominal obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168 000 primary care patients in 63 countries. Circulation, 116(17):1942-1951.

[5]Berghöfer, A., Pischon, T., Reinhold, T., Apovian, C.M., Sharma, A.M., Willich, S.N., 2008. Obesity prevalence from a European perspective: a systematic review. BMC Public Health, 8(1):200.

[6]Brock, D.W., Thomas, O., Cowan, C.D., Allison, D.B., Gaesser, G.A., Hunter, G.R., 2009. Association between insufficiently physically active and the prevalence of obesity in the United States. J. Phys. Act. Health, 6(1):1-5.

[7]Christian, A.H., Mochari, H., Mosca, L.J., 2009. Waist circumference, body mass index, and their association with cardiometabolic and global risk. J. Cardiometab. Syndr., 4(1):12-19.

[8]Ckene, I.S., Miller, N.H., 1997. Cigarette smoking, cardiovascular disease, and stroke: a statement for healthcare professionals from the American Heart Association. American Heart Association Task Force on Risk Reduction. Circulation, 96(9):3243-3247.

[9]de Rooij, S.R., Nijpels, G., Nilsson, P.M., Nolan, J.J., Gabriel, R., Bobbioni-Harsch, E., Mingrone, G., Dekker, J.M., Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) Investigators, 2009. Low-grade chronic inflammation in the relationship between insulin sensitivity and cardiovascular disease (RISC) population: associations with insulin resistance and cardiometabolic risk profile. Diabetes Care, 32(7):1295-1301.

[10]Hauner, H., Bramlage, P., Lösch, C., Schunkert, H., Wasem, J., Jöckel, K.H., Moebus, S., 2008. Overweight, obesity and high waist circumference: regional differences in prevalence in primary medical care. Dtsch. Arztebl. Int., 105(48):827-833.

[11]He, Y., Lam, T.H., Jiang, B., Wang, J., Sai, X., Fan, L., Li, X., Qin, Y., Hu, F.B., 2008. Passive smoking and risk of peripheral arterial disease and ischemic stroke in Chinese women who never smoked. Circulation, 118(15):1535-1540.

[12]Ho, S.C., Chen, Y.M., Woo, J.L., Leung, S.S., Lam, T.H., Janus, E.D., 2001. Association between simple anthropometric indices and cardiovascular risk factors. Int. J. Obes., 25(11):1689-1697.

[13]Janiszewski, P.M., Janssen, I., Ross, R., 2007. Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors? Diabetes Care, 30(12):3105-3109.

[14]Janssen, I., Katzmarzyk, P.T., Ross, R., 2004. Waist circumference and not body mass index explains obesity-related health risk. Am. J. Clin. Nutr., 79(3):379-384.

[15]Kip, K.E., Marroquin, O.C., Kelley, D.E., Johnson, B.D., Kelsey, S.F., Shaw, L.J., Rogers, W.J., Reis, S.E., 2004. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the women’s ischemia syndrome evaluation (WISE) study. Circulation, 109(6):706-713.

[16]Koster, A., Leitzmann, M.F., Schatzkin, A., Mouw, T., Adams, K.F., van Eijk, J.T., Hollenbeck, A.R., Harris, T.B., 2008. Waist circumference and mortality. Am. J. Epidemiol., 167(12):1465-1475.

[17]Ley, C.J., Lees, B., Stevenson, J.C., 1992. Sex- and menopause-associated changes in body-fat distribution. Am. J. Clin. Nutr., 55(5):950-954.

[18]Lofgren, I., Herron, K., Zern, T., West, K., Patalay, M., Shachter, N.S., Koo, S.I., Fernandez, M.L., 2004. Waist circumference is a better predictor than body mass index of coronary heart disease risk in overweight premenopausal women. J. Nutr., 134(5):1071-1076.

[19]Matthews, D.R., Hosker, J.P., Rudenski, A.S., Naylor, B.A., Treacher, D.F., Turner, R.C., 1985. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28(7):412-419.

[20]Mokdad, A.H., Ford, E.S., Bowman, B.A., Dietz, W.H., Vinicor, F., Bales, V.S., Marks, J.S., 2003. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA, 289(1):76-79.

[21]NHLBI Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, 1998. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Institutes of Health. Obes. Rev., 6(Suppl. 2):51S-209S.

[22]Ogden, C.L., Carroll, M.D., Curtin, L.R., McDowell, M.A., Tabak, C.J., Flegal, K.M., 2006. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA, 295(13):1549-1555.

[23]Park, S.H., Choi, S.J., Lee, K.S., Park, H.Y., 2009. Waist circumference and waist-to-height ratio as predictors of cardiovascular disease risk in Korean adults. Circ. J., 73(9):1643-1650.

[24]Rexrode, K.M., Carey, V.J., Hennekens, C.H., Walters, E.E., Colditz, G.A., Stampfer, M.J., Willett, W.C., Manson, J.E., 1998. Abdominal adiposity and coronary heart disease in women. JAMA, 280(21):1843-1848.

[25]Sidik, S.M., Rampal, L., 2009. The prevalence and factors associated with obesity among adult women in Selangor, Malaysia. Asia Pac. Fam. Med., 8(1):2.

[26]Wahrenberg, H., Hertel, K., Leijonhufvud, B.M., Persson, L.G., Toft, E., Arner, P., 2005. Use of waist circumference to predict insulin resistance: retrospective study. BMJ, 330(7504):1363-1364.

[27]Wildman, R.P., Gu, D., Reynolds, K., Duan, X., Wu, X., He, J., 2005. Are waist circumference and body mass index independently associated with cardiovascular disease risk in Chinese adults? Am. J. Clin. Nutr., 82(6):1195-1202.

[28]Wu, Y.F., 2006. Overweight and obesity in China. BMJ, 333(7564):362-363.

[29]Yoshida, D., Toyomura, K., Fukumoto, J., Ueda, N., Ohnaka, K., Adachi, M., Takayanagi, R., Kono, S.J., 2009. Waist circumference and cardiovascular risk factors in Japanese men and women. Atheroscler. Thromb., 16(4):431-441.

[30]Zhu, S., Wang, Z., Heshka, S., Heo, M., Faith, M.S., Heymsfield, S.B., 2002. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am. J. Clin. Nutr., 76(4):743-749.

[31]Zhu, S., Heshka, S., Wang, Z., Shen, W., Allison, D.B., Ross, R., Heymsfield, S.B., 2004. Combination of BMI and waist circumference for identifying cardiovascular risk factors in whites. Obesity, 12(4):633-645.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - Journal of Zhejiang University-SCIENCE