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Objective: To test the hypothesis that a single measurement, waist circumference, might be used to identify people at health risk both from being overweight and from having a central fat distribution.

Design: A community derived random sample of men and women and a second, validation sample.

Setting: North Glasgow.

Subjects: 904 men and 1014 women (first sample); 86 men and 202 women (validation sample).

Main outcome measures: Waist circumference, body mass index, waist:hip ratio.

Results: Waist circumference >/=94 cm for men and >/=80 cm for women identified subjects with high body mass index (>/=25 kg/m²) and those with lower body mass index but high waist:hip ratio (>/=0.95 for men, >/=0.80 women) with a sensitivity of >96% and specificity >97.5%. Waist circumference >/=102 cm for men or >/=88 cm for women identified subjects with body mass index >/=30 and those with lower body mass …