National Cancer Institute
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    Measure Name: Waist to Hip Ratio, Waist Circumference
    Current Description: Both the absolute amount of central fat (1,2) and the relative amount of fat distributed in central versus peripheral fat depots (3,4) have been shown to be predictive of multiple adiposity-related comorbidities and may affect intervention response (5-7). Both of these measures have been reported to correlate closely with visceral and subcutaneous adipose tissue measured by DXA (suggested) or MRI (8.9). To minimize variability in WHR, it is critical that investigators utilize uniform landmarks, with waist circumference measured at the iliac crest and hip circumference measured at the level of the trochanters as utilized by the National Center for Health Statistics in National Health and Nutrition Examination Survey studies (10). It should be noted that the abdominal circumference measured at the midpoint between the inferior border of the ribcage and the superior aspect of the iliac crest has been reported to be a better correlate of central adiposity in some studies (11). However, the NIH method is recommended to allow for better comparisons with existing National Health and Nutrition Examination Survey and other data.

1. SK Fried ML, K Karastergiou. Shaping fat distribution: new insights into the molecular determinants of depot- and sex-dependent adipose biology. Obesity
(Silver Spring) 2015;23:1345-1352.
2. Pouliot M, Despres J, Lemieux S, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue
accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994;73:460-468.
3. Larsson B, Svarsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular diseaseand death: 13 year follow up of participants in the study of men born in 1913. Br Med J 1984;288:1401-1404.
4. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L. Distibution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J 1984;289:1257-1261.
5. Tchernof A, Despres J. Pathophysiology of human visceral obesity: an update. Physio Rev 2013;93:359-404.
6. Bosy-Westphal A, Kahlhofer J, Lagerpusch M, Skurk T, Muller M. Deep body composition phenotyping during weight cycling: relevance to metabolic efficiency and metabolic risk. Obes Rev 2015;16:36-44.
7. Barreira T, Staiano A, Harrington D, et al. Anthropometric correlates of total body fat, abdominal adiposity, and cardiovascular disease risk factors in a biracial sample of men and women. Mayo Clin Proc 2012;87:452-460.
8. Kamel E, McNeill G, Han T, et al. Measurement of abdominal fat by magnetic resonance imaging, dual-energy X-ray absorptiometry and anthropometry in nonobese men and women. Int J Obes 1999;23:686-692.
9. Ludescher B, Machann J, Eschweiler G, et al. Correlation of fat distribution in whole body MRI with generally used anthropometric data. Invest Radio 2009;44: 712-719.
10. National Health and Nutrition Examination Survey (NHANES). National Center for Health Statistics (NCHS) anthropometry procedures manual. http://wwwcdcgov/nchs/data/nhanes/nhanes_11_12/Anthropometry_Procedures_Manualpdf. Published 2011. AQ8 Accessed
11. Ma W, Yang C, Shih S, et al. Measurement of waist cirucmference: midabdominal or iliac crest? Diabetes Care 2013;36:1660-1666.
DateFull NameAction
3/16/2018 1:49:40 PMPaul MacLean View
3/16/2018 1:48:15 PMPaul MacLean View
3/16/2018 1:41:23 PMPaul MacLean View
2/5/2018 12:13:17 PMTanya Agurs-Collins View
2/5/2018 12:12:54 PMTanya Agurs-Collins View
3/27/2017 5:22:22 PMPaul MacLean View
3/27/2017 5:21:35 PMPaul MacLean View
3/27/2017 4:34:13 PMPaul MacLean View
10/25/2016 4:05:53 PMRebecca Seguin View
10/25/2016 1:31:46 PMRebecca Seguin View
10/25/2016 1:31:13 PMRebecca Seguin View
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