Abdominal obesity in ELSA-Brasil (Brazil’s Longitudinal Study of Adult Health): construction of a latent gold standard and evaluation of the accuracy of diagnostic indicators

Abstract This study evaluated the accuracy of abdominal obesity (AO) indicators, defining a latent variable as the gold standard. The study included 12,232 participants of the ELSA-Brasil (Brazil’s Longitudinal Study of Adult Health), between 35 and 74 years of age. Three AO indicators were evaluated: waist circumference (WC), waist hip ratio (WHR) and conicity index (C index). Analyses were stratified by sex and race/skin color. All groups had a high prevalence of AO, being greater among white men (~70%) and black women (~60%). A high incidence of WC was observed for men, WHR and C index between men and women for discriminating latent AO. The following cutoff points for AO indicators were identified among white, brown and black men, respectively: WC: 89.9cm; 90.2cm and 91.7cm; WHR: 0.92; 0.92 and 0.90; C index: 1.24; 1.24 and 1.24. The cutoff points identified among white, brown and black women were, respectively: WC: 80.4cm, 82.7cm and 85.4cm; WHR: 0.82; 0.83 and 0.84; C index: 1.20; 1.22 and 1.19 The WC among men and the WHR and C index among men and women presented high power to discriminate latent AO, the C index being the best indicator.