Optimal Waist Circumference Cutoffs for Abdominal Obesity in Chinese

  • Weiping Jia
  • Jiemin Pan


Obesity has become a global epidemic and is a major risk factor for the development of metabolic abnormalities and cardiovascular disease. With the rapid economic development in China, the prevalence of overweight and obesity has been rising, estimated 22.4% of the adult population is overweight and 3.01% is obese in 1990s. It is categorized as abdominal obesity if fat is accumulated in the abdomen. Theoretically, abdominal obesity should be determined by visceral adipose tissue (VAT) precisely measured by magnetic resonance imaging (MRI) or computerized tomography (CT) scanning. While, waist circumference is widely used clinically to estimate the abdominal fat for its convenience and strong correlation with VAT. The waist circumference increased with aging in Chinese population and was quite similar in men and women especially in the subgroup with age over 60 years. Based on a cross-sectional survey, the accumulation of visceral fat at the level of visceral fat area (VFA) over 80 cm2 in Chinese linked with high prevalence of the metabolic syndrome (MetS). The corresponding waist circumference cut-offs were 87.5 cm in men and 84.3 cm in women. Therefore, it was demonstrated that the optimal cut-offs of waist circumference were 90 cm in men and 85 cm in women. Another prospective study demonstrated that the MetS based on the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) definition was a significant predictor for the development of CVD in total subjects. This study furthermore confirmed that the waist circumference cut-offs with 90 cm in men and 85 cm in women were more suitable than the IDF recommended in Chinese population.


Cholesterol Obesity Platinum Stratification Triglyceride 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Body mass index


C-reactive protein


Computerized tomography


Cardiovascular disease


Free fatty acids


Fasting plasma glucose


International Diabetes Federation


The Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults


Metabolic syndrome


Multinational monitoring of trends and determinants in cardiovascular disease


Magnetic resonance imaging


National Cholesterol Education Program Adult Treatment Panel III


Retinol binding protein 4


Receiver operating characteristic


Visceral adipose tissue


Visceral fat area


Waist circumference


World Health Organization


Waist-to-hip ratio



This work was funded by the Major Program of Shanghai Municipality for Basic Research (08dj1400601), Chinese National 973 Project (2007CB914702), and Project for Shanghai Key Laboratory of Diabetes Mellitus (08DZ2230200).


  1. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome——a new world wide definition. Lancet. 2005;366:1059–62.PubMedCrossRefGoogle Scholar
  2. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome——a new world wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;23:469–80.PubMedCrossRefGoogle Scholar
  3. Bao Y, Lu J, Wang C, Yang M, Li H, Zhang X, Zhu J, Lu H, Jia W, Xiang K. Optimal waist circumference cutoffs for abdominal obesity in Chinese. Atherosclerosis. 2008;201:378–84.PubMedCrossRefGoogle Scholar
  4. Chinese Center for Disease Control and Prevention. Guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci. 2004;17(suppl):1–36.Google Scholar
  5. Despres J-P, Lemiex I. Abdominal obesity and metabolic syndrome. Nature. 2006;444:881–7.PubMedCrossRefGoogle Scholar
  6. Examination Committee of Criteria for ‘Obesity Disease’ in Japan. Japan Society for the Study of Obesity: new criteria for ‘obesity disease’ in Japan. Circ J. 2002;66:987–92.CrossRefGoogle Scholar
  7. Feng Y, Hong X, Li Z, Zhang W, Jin D, Liu X, Zhang Y, Hu F, Wei L, Zang T, Xu X and Xu X. Prevalence of metabolic syndrome and its relation to body composition in a Chinese rural population. Obesity. 2006;14:2089–98.PubMedCrossRefGoogle Scholar
  8. He Y, Jiang B, Wang J, Feng K, Chang Q, Fan L, Li X, Hu F. Prevalence of the metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population. J Am Coll Cardiol. 2006;47:1588–94.PubMedCrossRefGoogle Scholar
  9. Jia W, Xiang K, Chen L, Lu J and Wu Y. Epidemiological study on obesity and its comorbidities in urban Chinese older than 20 years of age in Shanghai, China. Obesity reviews. 2002;3:157–65.PubMedCrossRefGoogle Scholar
  10. Jia W, Lu J, Xiang K, Bao Y, Lu H and Chen L. Predition of abdominal visceral obesity from body mass index, waist circumference and waist-hip ratio in Chinese adults: receiver operating characteristic curve analysis. Biomed Environ Sci. 2003;16:206–11.PubMedGoogle Scholar
  11. Jia W, Wu H, Bao Y, Wang C, Lu J, Zhu J and Xiang K. Association of serum retinol-binding protein 4 and visceral adiposity in Chinese subjects with and without type 2 Diabetes. J Clin Endocrinol Metab. 2007;92:3224–9.PubMedCrossRefGoogle Scholar
  12. Jiang S, Bao Y, Hou X, Fang Q, Wang C, Pan J, Zuo Y, Zhong W, Xiang K, Jia W. Serum C-reactive protein and risk of cardiovascular events in middle-aged and older chinese population. Am J Cardiol. 2009;103:1727–31.PubMedCrossRefGoogle Scholar
  13. Joint Committee for Developing Chinese guidelines on Prevention and Treatment of Dyslipidemia in Adults. [Chinese guidelines on prevention and treatment of dyslipideia in adults]. Zhonghua Xin Xue Guan Bing Za Zhi. 2007;35:390–419.Google Scholar
  14. Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med. 1989;149:1514–20.PubMedCrossRefGoogle Scholar
  15. Kim JA, Choi CJ, Yum KS. Cut-off values of visceral fat area and waist circumference: diagnostic criteria for abdominal obesity in a Korean population. J Korean Med Sci. 2006;21:1048–53.PubMedCrossRefGoogle Scholar
  16. Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, Kahn R. Association for weight management and obesity prevention; NAASO; Obesity Society; American Society for Nutrition; American Diabetes Association. Diabetes Care. 2007;30:1647–52.PubMedCrossRefGoogle Scholar
  17. Lemieux I, Pascot A, Prud’homme D, Alméras N, Bogaty P, Nadeau A, Bergeron J, Després JP. Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol. 2001;21:961–7.PubMedCrossRefGoogle Scholar
  18. Reaven GM. Banting lecture. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–607.PubMedCrossRefGoogle Scholar
  19. Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol. 2006;64:355–65.Google Scholar
  20. Ross R, Berentzen T, Bradshaw AJ, Janssen I, Kahn HS, Katzmarzyk PT, Kuk JL, Seidell JC, Snijder MB, Søensen TI, Després JP. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obes Rev. 2008;9:312–25.PubMedCrossRefGoogle Scholar
  21. Scherer PE. Adipose tissue: from lipid storage compartment to endocrine organ. Diabetes. 2006;55:1537–45.PubMedCrossRefGoogle Scholar
  22. Wang C, Hou X, Bao Y, Pan J, Zuo Y, Zhong W, Jia W, Xiang K. The metabolic syndrome increased risk of cardiovascular events in Chinese——A community based study. Int J Cardiol. 2010;139:159–65.Google Scholar
  23. WHO/NUT/NCD. Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity.Geneva: WHO; 1998.Google Scholar
  24. Yang W, Reynolds K, Gu D, Chen J, He J. A comparison of two proposed definitions for metabolic syndrome in the Chinese adult population. Am J Med Sci. 2007;334:184–9.PubMedCrossRefGoogle Scholar
  25. Ye Y, Bao Y, Hou X, Pan X, Wu H, Li H, Wang C, Tang J, Lu H, Xiang K, Jia W. Identification of waist circumference cutoffs for abdominal obesity in the Chinese population: a 7.8-year follow-up study in the Shanghai urban area. Int J Obestiy. 2009;33:1058–62.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Endocrinology and MetabolismShanghai Jiao Tong University affiliated Sixth People’s HospitalShanghaiChina

Personalised recommendations