Choosing an index for abdominal obesity: an opportunity for epidemiologic clarification

J Clin Epidemiol. 1993 May;46(5):491-4. doi: 10.1016/0895-4356(93)90027-x.


Despite numerous reports that abdominal obesity is related to disease risk, the study of body-fat distribution remains a largely empirical science. Elucidation of the pathophysiologic linkage between abdominal obesity and disease would be better served by generating hypotheses and testing them--the process of deductive science. Physiologists have proposed that adipose tissue of the intra-abdominal compartment (that drained by the portal vein) contributes strongly to atherosclerosis. If this is so, then the volume of the intra-abdominal fat depot might be better correlated with disease states than a less specific anthropometric index such as the waist-to-hip girth ratio. Alternative abdominal-obesity indices (e.g. sagittal abdominal diameter divided by thigh girth) could be tested in epidemiologic studies to improve our pathophysiologic understanding of how body-fat distribution is related to atherosclerosis and other diseases.

Publication types

  • Comment
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abdomen*
  • Anthropometry
  • Body Constitution
  • Epidemiologic Methods
  • Humans
  • Mathematics
  • Morbidity
  • Obesity / complications
  • Obesity / diagnosis*