Background/Aims: Although a variety of classical body measurements have been used to assess adiposity, it is still uncertain which is the best indicator to predict effects arising from the accumulation of body fat (BF) in the elderly. The objective of this study was to analyze different classical anthropometric and body composition measurements and their potential for predicting metabolic syndrome (MS) in elderly women. Methods: There were 113 women (60–83 years old) participating in the study, all of whom had their anthropometric, biochemical, hemodynamic and health conditions evaluated. Statistical analysis consisted of correlation coefficient and receiver operating characteristic (ROC) curves, and calculation of the area under the curve. Results: The waist-hip ratio (WHR) and waist circumference correlated with three (hyperglycemia, hypertriglyceridemia and low concentrations of high density lipoprotein-cholesterol) of the seven cardiometabolic risk factors studied. Body mass index, BF, percentage of BF, and the sum of skinfolds were less related to metabolic risk factors. Among the indicators used to characterize central adiposity, WHR was the index that showed the greatest area under the ROC curve. Conclusions: It is suggested that the WHR, an indicator of abdominal adiposity, should be incorporated into the identification of risk of MS in elderly women.

1.
Pereira RA, Sichieri R, Marins VMR: Razão cintura/quadril como preditor de hipertensão arterial. Cad Saúde Pública 1999;15:333–344.
2.
Miranda P, Defronzo R, Califf R, Guyton J: Metabolic syndrome: definition, pathophysiology, and mechanisms. Am Heart J 2005;149:33–45.
3.
Moraes EM: Aterosclerose: diagnóstico e tratamento; in Moraes EM: Princípios Básicos de Geriatria e Gerontologia. Belo Horizonte, COOPMED, 2008, pp 189–201.
4.
Lichnovská R, Gwozdziewiczová S, Hrebícek J: Gender differences in factors influencing insulin resistance in elderly hyperlipemic non-diabetic subjects. Cardiovasc Diabetol 2002;1:1–10.
5.
Woo J, Ho S, Yu A, Sham A: Is waist circunference a useful measure in predicting health outcomes in the elderly? Int J Obes Relat Metab Dosrd 2002;26:1349–1355.
6.
Wannamethee S, Shaper A, Morris R, Whincup P: Measures of adiposity in the identification of metabolic abnormalities in elderly men. Am J Clin Nutr 2005;81:1313–2131.
7.
Turcato E, Bosello O, Francesco VD, Harris T, Zoico E, Bissoli L, Fracassi E, Zamboni M: Waist circumference and abdominal sagittal diameter as surrogates of body fat distribution in the elderly: their relation with cardiovascular risk factors. Int J Obes Relat Metab Disord 2000;24:1005–1010.
8.
Snijder MB, Dekker JM, Visser M, Bouter LM, Stehouwer CD, Kostense PJ, Yudkin JS, Heine RJ, Nijpels G, Seidell JC. Associations of hip and thigh circumferences independent of waist circumference with the incidence of type 2 diabetes: the Hoorn Study. Am J Clin Nutr 2003;77:1192–1197.
9.
Cabrera MAS, Wajngarten M, Gebara OCE, Diament J: Relação do índice de massa corporal, da relação cintura-quadril e da circunferência abdominal com a mortalidade em mulheres idosas: seguimento de 5 anos. Cad Saúde Pública. 2005;21:767–775.
10.
Tyagi R, Kapoor S, Kapoor A: Body composition and fat distribution pattern of urban elderly females, Delhi, India. Coll Antropol 2005;29:493–498.
11.
Brundavani V, Murthy S, Kurpad A: Estimation of deep-abdominal-adipose-tissue (DAAT) accumlation from simple anthropometric measurements in Indian men and Women. Eur J Clin Nutr 2006;60:658–666.
12.
Mukuddem-Petersen J, Snijder M, Dam R, Dekker J, Bouter L, Stehouwer C, Heine RJ, Nijpels G, Seidell JC: Sagittal abdominal diameter: no advantage compared with other anthropometric syndrome in elderly from the Hoorn Study. Am J Clin Nutr 2006;84:995–1002.
13.
Krause MP, Hallage T, Gama MPR, Sasaki JE, Miculis CP, Buzzachera CF, Franklin C, Silva SG: Associação entre Perfil lipídico e Adiposidade Corporal em mulheres com mais de 60 Anos de idade. Arq Bras Cardiol 2007;89:163–169.
14.
Kullberg J, von Below C, Lönn L, Lind L, Ahlström H, Johansson L: Practical approach for estimation of subcutaneous and visceral adipose tissue. Clin Physiol Funct Imaging 2007;27:148–153.
15.
Nilsson G, Hedberg P, Jonason T, Lonnberg I, Tenerz A, Forberg R, Ohrvik J: Waist circumference alone predicts insulin resistance as good as the metabolic syndrome in elderly women. Eur J Intern Med 2008;19:520–526.
16.
Sampaio LR, Figueiredo VC: Correlação entre o índice de massa corporal e os indicadores antropométricos de distribuição de gordura corporal em adultos e idosos. Rev Nutr 2005;18:53–61.
17.
Friedewald W, Levy R, Fredrickson D: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499–502.
18.
National Cholesterol Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health: Executive summary of the third report of the National Cholesterol Education Program (2002): expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf (accessed Dec 15, 2008).
19.
US Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute, National High Blood Pressure Education Program (2004): The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf (Accessed Dec 15, 2008).
20.
World Health Organization (WHO): El Estado Físico: uso e interpretación de la antropometría. Série de Informes Técnicos 854. Geneva, WHO, 1995, pp 9–14.
21.
Heyward VH, Stolarczyk LM: Avaliação da Composição Corporal Aplicada, ed 1. São Paulo, Manole, 2000, vol 1, p 243.
22.
Gomes M, Rech C, Gomes M, Santos D: Correlação entre índices antropométricos e distribuição de gordura corporal em mulheres idosas. Rev Bras Cineantropom Desempenho Hum 2006;8:16–22.
23.
Klein S, Allison D, Heymsfield S, Kelley D, Leibel R, Nonas C, et al: Waist circumference and cardiometabolic risk: a consensus statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Am J Clin Nutr 2007;85:1197–1202.
24.
Lipschitz D: Screening for nutritional status in the elderly. Prim Care 1994;21:55–67.
25.
Deurenberg P, Kooij KVD, Evers P, Hulshof T: Assessment of body composition by bioelectrical impedance in a population aged >60 y. Am J Clin Nutr 1990;51:3–6.
26.
Callegari-Jacques S: Bioestatística: princípios e aplicações. Porto Alegre, Artmed, 2006, vol 1, p 255.
27.
Pagano M, Gauvreau K: Princípios de Bioestatística. São Paulo, Pioneira, 2008, vol 1, p 522.
28.
Erdreich L, Lee E: Use of relative operating characteristic analysis in epidemiology. Am J Epidemiol 1981;114:649–662.
29.
World Health Organization: Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. 1. Diagnosis and classification of diabetes mellitus. Geneva, WHO, 1999, p 59.
30.
Storti K, Brach J, FitzGerald S, Bunker C, Kriska A: Relationships among body composition measures in community-dwelling older women. Obesity 2006;14:244–251.
31.
Alemán-Mateo H, Esparza-Romero J, Valencia M: Antropometría y compoosición corporal en personas mayores de 60 años: importância de la actividade física. Salud Pública Méx 1999;41:309–316.
32.
Bedogni G, Pietrobelli A, Heymsfield S, Borghi A, Mancieri A, Morini P, Battistini N, Salvioli G: Is body mass index a measure of adiposity in elderly women? Obes Res 2001;9:17–20.
33.
Haapala I, Hirvonem A, Niskanen L, Uusitupa M, Kröger H, Alhava E, Nissinen A: Anthropometry, bioelectrical impedance and dual-energy X-ray absorptiometry in the assessment of body composition in elderly Finnish Women. Clin Physiol Funct Imaging 2002;22:383–391.
34.
Sun O, van Dam RM, Spiegelman D, Heymsfield SB, Willett WC, Hu FB: Comparison of dual-energy x-ray absorptiometric and anthropometric measures of adiposity in relation to adiposity-related biologic factors. Am J Epidemiol 2010;172:1442–1454.
35.
Marafon LP, Cruz IBM, Schwanke CHA, Moriguchi EH: Preditores cardiovasculares da mortalidade em idosos longevos. Cad Saúde Pública 2003;19:799–808.
36.
Zepeda M, Camacho M, Alva M: Métodos y técnicas de medición de la composición corporal y su uso en indivíduos de la tercera edad. Nutrición Clínica 2002;5:88–97.
37.
Visscher T, Seidell J, Molarius A, van der Kuip D, Hofman A, Witteman J: A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study. Int J Obes Relat Metab Disord 2001;25:1730–1735.
38.
He Q, Engelson E, Wang J, Kenya S, Ionescu G, Heymsfield S, Kotler DP: Validation of an elliptical anthropometric model to estimate visceral compartment area. Obes Res 2004;12:250–257.
39.
Hughes V, Roubenoff R, Wood M, Frontera WR, Evans WJ, Singh MAF: Anthropometric assessment of 10-y changes in body composition in the elderly. Am J Clin Nutr 2004;80:475–482.
40.
Esmaillzadeh A, Mirmiran P, Azizi F: Comparative evaluation of anthropometric measures to predict cardiovascular risk factors in Tehranian adult women. Public Health Nutr 2006;9:61–69.
41.
Koning L, Merchant A, Pogue J, Anand S: Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 2007;28:850–856.
42.
Knowles KM, Paiva LL, Sanchez SE, Revilla L, Lopez T, Yasuda MB, Yanez ND, Gelaye B, Williams MA: Waist circumference, body mass index, and other measures of adiposity in predicting cardiovascular disease risk factors among Peruvian adults. Int J Hypertens 2011;2011:931402.
43.
Folsom A, Kaye S, Sellers T, Hong C, Cerhan J, Potter J, Prineas RJ: Body fat distribution and 5-year risk of death in older women. JAMA 1993;269:483–487.
44.
Price GM, Uauy R, Breeze E, Bulpitt CJ, Fletcher AE: Weight, shape, and mortality risk in older persons: elevated-waist hip ratio, not high body mass index, is associated with a greater risk of death. Am J Clin Nutr 2006;84:449–460.
45.
Seidell JC, Oosterlee A, Thijssen MA, Burema J, Deurenberg P, Hautvast JG, Ruijs JH: Assessment of intra-abdominal and subcutaneous abdominal fat: relation between anthropometry and computed tomography. Am J Clin Nutr 1987;45:7–l3.
46.
Bouchard C, Bray GA, Hubbard VS: Basic and clinical aspects of regional fat distribution. Am J Clin Nutr 1990;52:946–950.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.