Relationship of metabolic variables to abdominal adiposity measured by different anthropometric measurements and dual-energy X-ray absorptiometry in obese middle-aged women

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Abstract
OBJECTIVES: To investigate how abdominal adiposity assessed by different anthropometric measurements and dual-energy X-ray absorptiometry measurements is associated with metabolic risk factors for cardiovascular disease and non-insulin-dependent diabetes mellitus in obese women. DESIGN: Cross-sectional study. SUBJECTS: Forty-three healthy, obese, middle-aged women (age: 29–64 y, BMI: 28–42 kg/m2). MEASUREMENTS: (1) Anthropometry: waist circumference, waist-to-hip ratio, waist-to-height ratio, abdominal sagittal and transverse diameters and their ratio. (2) Dual-energy X-ray absorptiometry: the amount of total and regional abdominal fat. (3) Metabolic measurements: serum total, VLDL, LDL, HDL cholesterol, triglycerides, fasting and postglucose serum insulin and glucose. RESULTS: After adjustment for age and BMI, all the anthropometric measurements except waist-to-hip ratio and waist-to-height ratio related significantly to HDL and LDL cholesterol. On the other hand, waist-to-hip ratio and waist-to-height ratio showed an association with triglycerides. In addition, all the anthropometric measurements except transverse diameter correlated significantly with fasting insulin and fasting glucose. Waist-to-hip ratio was the only measure that associated with 2 h glucose concentration. The differences between the correlation coefficients were not statistically significant in the z-transformed correlation coefficient test. ƒAs to dual-energy X-ray absorptiometry results, the region from the dome of diaphragm to the top of femur (`abdominal fat') and the area between the first and the fourth lumbal vertebrae (`upper lumbal fat') inversely related to HDL cholesterol and positively to triglycerides. Both of these regions correlated significantly with fasting insulin, and `upper lumbal fat' associated also with fasting glucose even after adjustment for age and BMI. CONCLUSION: None of the anthropometric measurements (waist circumference, waist-to-hip ratio, waist-to-height ratio or sagittal diameter) was significantly superior to others to assess the metabolic risk profile. `Upper lumbal fat' (the area between the first and the fourth lumbal vertebrae) measured by dual-energy X-ray absorptiometry discerned obese women with elevated fasting insulin and fasting glucose.

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