Impact of waist circumference reduction on cardiovascular risk in treated obese subjects.

Background: The World Health Organization reports that waist circumference (WC) independent of weight or body mass index (BMI) predicts cardiovascular risk. We undertook this study to determine the change of prevalence in comorbidities associated with obesity and cardiovascular risk after favorably modifying WC.

Methods: We studied 153 nondiabetic patients with obesity (BMI =30 kg/m²) and WC in women =80 cm and in men =94 cm who entered a weight control program for 2 years. We evaluated the evolution of their anthropometric measurements and metabolic status. Ninety patients (58.8%) completed the study. With the prior acceptance of the patients, they received nutritional advice and psychological and physical activity support during their monthly visits. Also, anthropometric measurements and blood pressure were evaluated. At the beginning and after each 6 months, glucose, total cholesterol, HDL cholesterol and triglycerides were determined. At the beginning and at the end of study the Framingham risks were evaluated.

Results: Of the 90 patients, 37 (group 1) decreased their WC: in women <80 cm and in men <94 cm. In 53 patients (group 2) there were no significant changes. Changes were shown in group 1 for blood pressure (from 36.6% to 21.6%), hyperglycemia >100 mg/dl decreased from 18.8% to 8.1%, triglycerides >150 mg/dl decreased from 28.8% to 18.9% and Framingham risk at 10 years decreased.

Conclusions: There is a direct relationship between WC and cardiovascular risk. When WC decreases, cardiovascular risk is favorably modified. Measurement of WC is a good predictor of cardiovascular risk.