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Open Access Highly Accessed Research article

Waist circumference a good indicator of future risk for type 2 diabetes and cardiovascular disease

Reijo Siren12, Johan G Eriksson23456* and Hannu Vanhanen7

Author Affiliations

1 Health Centre of City of Helsinki, Helsinki, Finland

2 Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland

3 National Institute for Health and Welfare, Helsinki, Finland

4 Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland

5 Folkhalsan Research Center, Helsinki, Finland

6 Vasa Central Hospital, Vasa, Finland

7 The Social Insurance Institution of Finland (KELA), Helsinki, Finland

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BMC Public Health 2012, 12:631  doi:10.1186/1471-2458-12-631

Published: 9 August 2012



Abdominal obesity is a more important risk factor than overall obesity in predicting the development of type 2 diabetes and cardiovascular disease. From a preventive and public health point of view it is crucial that risk factors are identified at an early stage, in order to change and modify behaviour and lifestyle in high risk individuals.


Data from a community based study was used to assess the risk for type 2 diabetes, cardiovascular disease and prevalence of metabolic syndrome in middle-aged men. In order to identify those with increased risk for type 2 diabetes and/or cardiovascular disease sensitivity and specificity analysis were performed, including calculation of positive and negative predictive values, and corresponding 95% CI for eleven different cut-off points, with 1 cm intervals (92 to 102 cm), for waist circumference.


A waist circumference ≥94 cm in middle-aged men, identified those with increased risk for type 2 diabetes and/or for cardiovascular disease with a sensitivity of 84.4% (95% CI 76.4% to 90.0%), and a specificity of 78.2% (95% CI 68.4% to 85.5%). The positive predictive value was 82.9% (95% CI 74.8% to 88.8%), and negative predictive value 80.0%, respectively (95% CI 70.3% to 87.1%).


Measurement of waist circumference in middle-aged men is a reliable test to identify individuals at increased risk for type 2 diabetes and cardiovascular disease. This measurement should be used more frequently in daily practice in primary care in order to identify individuals at risk and when planning health counselling and interventions.

Waist circumference; Type 2 diabetes; Cardiovascular disease; Middle-aged men