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in recent years, considerable attention hasbeen given to the role of adiposity in thedevelopment of chronic diseases, leadingto speculations that some forms of fat distributionmay be more important in thecausation of cardiovascular diseases thanothers (1,2). Evidence for the strong re l ationshipbetween cardiovascular diseasesand adiposity has often been based on thea n t h ropometric indices of BMI and waistto-hipratio (WHR). BMI is a height-independentmeasure of weight often used as am e a s u re of whole body size and the degre eof fatness within populations. The use ofBMI is controversial, however, in partbecause its correlation with fatness is notconsistent across populations (3). WHRm e a s u res central fat deposition but is a poorm e a s u re of visceral fat mass, particularly inlean individuals (4). Waist circ u m f e rence isan aggregate measurement of the actualamount of total and abdominal fat accumulationand is a crucial correlate of thecomplexities found among obese and overweightpatients (5,6). Unlike the BMI, waistc i rc u m f e rence is not profoundly influ e n c e dby height (7) and is there f o re a better predictorof some cardiovascular diseases (8,9).Waist circ u m f e rence has also been shown tobe more correlated with levels of abdominalvisceral adipose tissue (9–13).Only a few studies examined the associationof waist circ u m f e rence with hypertensionand diabetes in populations of theAfrican diaspora (14,15). InvestigatingAfricans in the diaspora makes it possible todilute the potential confounding factors ofsocial class and race that occurs often inblack–white comparisons and to understandthe range of interactions that occur in widelycontrasting environments. This study examinesthe association of abdominal fat distribution(defined by waist circ u m f e re n c e )with hypertension and type 2 diabetes.
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