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Furthermore, standard BMI cutoffs underestimate obesity in this population. Therefore, we aimed to identify the best marker of obesity in individuals with SCI, considering both practicality, and ability to detect adiposity and CVD risk. Five anthropometric measures were evaluated: BMI; waist circumference (WC); waist-to-height ratio (WHtR); waist-to-hip ratio; and neck circumference. We evaluated relationships between these measures and abdominal and total body-fat percentage, seven cardiovascular metabolic risk factors (fasting insulin, glucose, glucose tolerance, triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol), and the Framingham risk score. BMI, WC, and WHtR were correlated with abdominal fat percentage. WC and WHtR were correlated with five metabolic risk factors as well as the Framingham risk score. WC is a more practical measure for an SCI population. The optimal cutoff for identifying adverse CVD risk in individuals with SCI was identified as WC \u226594\u2009cm, with 100% sensitivity and 79% specificity. We propose that WC is a simple, more sensitive alternative to BMI in this population that is easy to use in multiple settings. The cutoff provides a simple tool to predict adverse CVD risk profiles that can be used to guide risk management, as well as as a practical aid for individuals with SCI to maintain a healthy body composition.<\/jats:p>","DOI":"10.1089\/neu.2013.3042","type":"journal-article","created":{"date-parts":[[2013,9,26]],"date-time":"2013-09-26T17:52:59Z","timestamp":1380217979000},"page":"292-300","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":80,"title":["Waist Circumference Is the Best Index for Obesity-Related Cardiovascular Disease Risk in Individuals with Spinal Cord Injury"],"prefix":"10.1177","volume":"31","author":[{"given":"Henrike (Rianne) Joanna Cornelie","family":"Ravensbergen","sequence":"first","affiliation":[{"name":"Simon Fraser University","place":["Canada"]},{"name":"International Collaboration On Repair Discoveries (ICORD)","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott Alexander","family":"Lear","sequence":"additional","affiliation":[{"name":"Simon Fraser University","place":["Canada"]},{"name":"Simon Fraser University","place":["Canada"]},{"name":"Providence Health Care","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Elizabeth","family":"Claydon","sequence":"additional","affiliation":[{"name":"Simon Fraser University","place":["Canada"]},{"name":"International Collaboration On Repair Discoveries (ICORD)","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,2,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31802f0247"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101162"},{"issue":"1","key":"e_1_3_3_4_2","first-page":"S39","article-title":"The association of cardiovascular disease risk factors with abdominal obesity in Canada","volume":"157","author":"Reeder B.A.","year":"1997","unstructured":"Reeder B.A., , Senthilselvan A., , Despres J.P., , Angel A., , Liu L., , Wang H., , and Rabkin S.W. 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