OBJECTIVES: To investigate how abdominal adiposity assessed by different anthropometric measurements and dualenergy X-ray absorptiometry measurements is associated with metabolic risk factors for cardiovascular disease and non-insulin-dependent diabetes mellitus in obese women. DESIGN: Cross-sectional study. SUBJECTS: Forty-three healthy, obese, middle-aged women (age: 29±64 y, BMI: 28±42 kg/m 2 ). MEASUREMENTS: (1) Anthropometry: waist circumference, waist-to-hip ratio, waist-to-height ratio, abdominal sagittal and transverse diameters and their ratio. (2) Dual-energy X-ray absorptiometry: the amount of total and regional abdominal fat. (3) Metabolic measurements: serum total, VLDL, LDL, HDL cholesterol, triglycerides, fasting and postglucose serum insulin and glucose. RESULTS: After adjustment for age and BMI, all the anthropometric measurements except waist-to-hip ratio and waist-to-height ratio related signi®cantly to HDL and LDL cholesterol. On the other hand, waist-to-hip ratio and waistto-height ratio showed an association with triglycerides. In addition, all the anthropometric measurements except transverse diameter correlated signi®cantly with fasting insulin and fasting glucose. Waist-to-hip ratio was the only measure that associated with 2 h glucose concentration. The differences between the correlation coef®cients were not statistically signi®cant in the z-transformed correlation coef®cient test.As to dual-energy X-ray absorptiometry results, the region from the dome of diaphragm to the top of femur (`abdominal fat') and the area between the ®rst and the fourth lumbal vertebrae (`upper lumbal fat') inversely related to HDL cholesterol and positively to triglycerides. Both of these regions correlated signi®cantly with fasting insulin, and`upper lumbal fat' associated also with fasting glucose even after adjustment for age and BMI. CONCLUSION: None of the anthropometric measurements (waist circumference, waist-to-hip ratio, waist-to-height ratio or sagittal diameter) was signi®cantly superior to others to assess the metabolic risk pro®le.`Upper lumbal fat' (the area between the ®rst and the fourth lumbal vertebrae) measured by dual-energy X-ray absorptiometry discerned obese women with elevated fasting insulin and fasting glucose.

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