To quantify the fat distribution pattern in central obesity, truncal (neck, chest, and abdomen) and peripheral (bilateral upper part of the arms, thighs, and lower part of the legs) circumferences of the body were measured in Japanese women. Central obesity index (COI) was calculated as follows: sum of the truncal circumferences divided by sum of the bilateral peripheral circumferences. The mean COI of six women with Cushing's syndrome (1.028±0.056 [SD]) far exceeded that of 56 female controls (0.875 ±0.054), including 14 obese women (0.877 ±0.060) and 13 diabetic women (0.922 ±0.028). During the postoperative follow-up of the patients with Cushing's syndrome, the COIs decreased considerably. Because there is no requirement for special instruments or techniques, the measurement of COI is expected to be useful in the screening of Japanese women for Cushing's syndrome and as an indicator of response after treatment.
Hiramatsu R, Yoshida K, Sato T. A Body Measurement to Evaluate the Pattern of Fat Distribution in Central Obesity: A Screening and Monitoring Technique for Cushing's Syndrome. JAMA. 1983;250(23):3174–3178. doi:10.1001/jama.1983.03340230026022
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