Send This Page By E-mail
Print this page

BMI and WC comparable for identifying insulin-resistant patients' CV risk

Friday, October 13, 2006

Am J Cardiol 2006; 98: 1053-1056

US scientists have deemed that body mass index (BMI) and waist circumference (WC) measurements are equally good at identifying insulin-resistant patients at risk of cardiovascular disease (CVD).

"Insulin resistance and associated metabolic abnormalities occur more commonly in the overweight or obese, and these changes increase the risk of CVD," report Helk Farin, from Stanford University School in California, and team in the American Journal of Cardiology.

Determining a patient's BMI or WC can help to identify their risk profile, but until now scientists have battled over which measurement is more indicative of insulin resistance and its consequences.

The team assessed the insulin-mediated glucose uptake and lipoprotein profiles of 261 healthy adults and then determined how these factors related to their BMI and WC measurements.

Irrespective of the measure used, patients with higher levels of adiposity also showed elevated levels of plasma glucose and triglycerides.

However, high levels of total cholesterol and low-density lipoprotein cholesterol, (LDL-C) and a drop in high-density lipoprotein cholesterol (HDL-C) were only seen in patients with higher BMI values, not those with high WCs.

Overall, CVD risk factor values were almost identical in patients defined as overweight or obese, using the BMI, or those classified as abdominally obese, using WC criteria.

"It appears that either index of obesity, BMI or WC, will identify, to a comparable degree, those insulin-resistant patients with the associated metabolic abnormalities that increase CVD risk," they say.

They add that because more patients tend to be overweight and obese rather than specifically abdominally obese, "it would seem that measuring BMI may actually be of greater clinical utility."

This study comes at a time when medical opinion favors WC measurements; however, Farin et al argue that "although WC is a significant predictor of clinical outcomes linked to insulin resistance, considerable evidence has shown that overall obesity, as estimated by BMI, effectively identifies patients more likely to develop the clinical syndromes associated with the defect in insulin action."

They add: "It is certainly difficult to conclude from these data that BMI measurements provide less clinically relevant information than determinations of WC."