Waist Circumference, BMI, and Visceral Adipose Tissue in White Women and Women of African Descent

Abstract

Although waist circumference (WC) is a marker of visceral adipose tissue (VAT), WC cut-points are based on BMI category. We compared WC–BMI and WC–VAT relationships in blacks and whites. Combining data from five studies, BMI and WC were measured in 1,409 premenopausal women (148 white South Africans, 607 African–Americans, 186 black South Africans, 445 West Africans, 23 black Africans living in United States). In three of five studies, participants had VAT measured by computerized tomography (n = 456). Compared to whites, blacks had higher BMI (29.6 ± 7.6 (mean ± s.d.) vs. 27.6 ± 6.6 kg/m2, P = 0.001), similar WC (92 ± 16 vs. 90 ± 15 cm, P = 0.27) and lower VAT (64 ± 42 vs. 101 ± 59 cm2, P < 0.001). The WC–BMI relationship did not differ by race (blacks: β (s.e.) WC = 0.42 (.01), whites: β (s.e.) WC = 0.40 (0.01), P = 0.73). The WC–VAT relationship was different in blacks and whites (blacks: β (s.e.) WC = 1.38 (0.11), whites: β (s.e.) WC = 3.18 (0.21), P < 0.001). Whites had a greater increase in VAT per unit increase in WC. WC–BMI and WC–VAT relationships did not differ among black populations. As WC–BMI relationship did not differ by race, the same BMI-based WC guidelines may be appropriate for black and white women. However, if WC is defined by VAT, race-specific WC thresholds are required.

Site-specific differences in bone mineral density in black and white premenopausal South African women

“…Differences in body composition previously reported between black and white women from South Africa and the USA [9,10] may help to explain ethnic differences in BMD. Black South African women have less skeletal muscle mass and more fat mass than white South African women.…”

“…Black South African women have less skeletal muscle mass and more fat mass than white South African women. With increasing fat mass, black women in South Africa and the USA accumulate more fat in the periphery and less in the visceral adipose tissue (VAT) depot than their white counterparts [10,11]. Previously, fat mass has been shown to be positively associated with BMD in women as a result of increased mechanical loading and osteogenic hormones released from adipose tissue [12].…”

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

“…[28][29][30][31][32] Even after adjustment for either body mass index (BMI) or waist circumference (WC), measurements of visceral adipose tissue are lower in NHB than NHW women. [33][34][35][36] Consequently, the WC that predicts insulin resistance and cardiometabolic risk is 5 to 10 cm higher in NHB than NHW women because NHBs have more subcutaneous compared with visceral fat at a given WC than NHW women. 37,38 However, this racial difference in the WC of risk may not be clinically important because in every BMI category the prevalence of obesity is ≈50% higher in NHB than NHW women.…”

Review: Metabolic Syndrome in Black South African Women

“…[49][50][51] In a recent study of African women, waist circumference was left out of MetS criteria to uncover the principal determinants of the cardiometabolic components of the syndrome. Visceral fat was found not to correlate with any of the cardiometabolic components but trunk fat-free soft-tissue mass (FF-STM) and abdominal subcutaneous fat were found to positively and negatively modulate risk for the MetS, respectively.…”