Large waist circumference with normal BMI identifies a significant subset of Italian female patients with the metabolic syndrome–a high risk presentation?

Description

In this letter to the editor, Mombelli G et al. discuss the value of anthropometric variables to provide significant information and detect the metabolic syndrome (MS). They evaluated a large number of individuals in their Lipid Clinic in Milan and found that waist circumference (WC), HDL cholesterol, fasting glucose, systolic blood pressure and triglycerides were all significantly associated with the MS with the highest score given to WC. They also found that a large WC was more prevalent among women even in the normal weight BMI range group. In fact, in the normal BMI group, 17% of females and 18% of males had the MS. When considering individuals with normal BMI and large WC, 59 (21%) females and 1 (1%) males were identified and of those 59 females, 26 (44%) had a MS vs. none of the males. Thus, there is a disconnect between the occurrence of normal BMI and large WC, particularly in females. Recent studies have shown that an enlarged WC, without a high BMI, is in itself a risk factor for cardiovascular death. Thus, in this Mediterranean population, an elevated WC also appeared to be partly dissociated from an elevated BMI, especially in women, in whom such an elevated waist may possibly be associated with an increased cardiovascular risk.