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J Natl Med Assoc. 2018 Oct;110(5):519-527. doi: 10.1016/j.jnma.2018.01.001. Epub 2018 Feb 13.

Central Obesity in Africans: Anthropometric Assessment of Abdominal Adiposity and its Predictors in Urban Nigerians.

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Endocrinology Department, David Grant Medical Center, Travis AFB, CA 94535, USA; Uniformed Services University of the Health Sciences, USA. Electronic address:
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec H3A 1A2, Canada.
Department of Medicine, University College Hospital, Ibadan, Nigeria.



To assess the occurrence of central obesity and identify its predictors in urban Africans using anthropometric tools. Another objective was to evaluate the anthropometric indices and their interaction with various cardiovascular risk factors.


In an obesity survey in a major Nigerian city, we measured the prevalence of central obesity in 998 randomly selected men and women using the IDF (International Diabetes Federation) criteria. Normalized values of three anthropometric indices, waist circumference (WC), WHR (waist-to-hip ratio) and WHtR (waist-to-height ratio) were also employed in assessing central adiposity and its predictors in the population.


Most (61%) female participants had central obesity compared with 9% of the males based on the IDF waist criteria. Higher income level and physical inactivity were associated with central obesity (p < 0.001). In multivariate analyses, older participants and women were more likely to have central obesity (p < 0.001), but men had higher WHR than women at the same body mass index. WC was a stronger predictor of glucose intolerance than WHR, whereas WHR was more predictive of hypertension than WC. WHR showed a strong relationship with hypertension but not with glucose intolerance. WHtR was predictive of plasma glucose and diastolic blood pressure. WC showed strongest correlation with other indices.


Central obesity was highly prevalent among women in this sample. It was associated with age, gender, socioeconomic status, physical inactivity, and it predicted glucose intolerance and hypertension. WC was a major determinant of both cardiovascular risk factors. It showed best correlation with other anthropometric indices.


Abdominal adiposity; Africans; Anthropometric indices; Central obesity; Epidemiology


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