hypertriglyCeridemiC body mass index

South Asians have a higher incidence of coronary heart disease (CHD) than individuals of European descent1 and present with first acute myocardial infarction at younger ages.2 In the study by Joshi et al,2 among the several CHD risk factors that differentiated native South Asians from those living in other countries was an increase in abdominal obesity. Of interest in this context is the suggestion by Lemieux and colleagues3 that the combination of abdominal obesity and an elevated triglyceride concentration comprise an entity designated as hypertriglyceridemic waist (HTG-waist) that identifies individuals with an “atherogenic metabolic triad,” characterized by “hyperinsulinemia, elevated apo B, small, dense LDL.” The association between an HTG-waist and abnormal coronary angiography has been confirmed in both men and women,3-5 and prospective studies have shown that an HTG-waist is a predictor of CHD.6,7 The cardiometabolic abnormalities subsumed under the rubric of HTGwaist are similar to the cluster of abnormalities associated with insulin resistance; and insulin resistance in nondiabetic individuals is associated with glucose intolerance, hyperinsulinemia, and an atherogenic lipoprotein profile, consisting of: hypertriglyceridemia; low high-density lipoprotein cholesterol (HDL-C) concentrations; small, dense lowdensity lipoprotein particles; and changes in apolipoprotein A-1 and apolipoprotein B concentrations.8-13 Abdominal obesity, as ascertained by determining waist circumference (WC), is associated with decreased insulin sensitivity and an increase in cardiometabolic risk factors.14-16 However, it appears that this is also the case if body mass index (BMI) is used as the index of excess adiposity.14-16 Furthermore, BMI and WC are themselves highly correlated; an obese WC in most individuals is accompanied by an obese BMI, and the correlation between a direct CardiometaboliC risk in south asian inhabitants of California: hypertriglyCeridemiC Waist vs hypertriglyCeridemiC body mass index