Fat distribution in relation to age, degree of obesity, smoking habits, parity and estrogen use: a cross-sectional study in 11,825 Dutch women participating in the DOM-project

Fat distribution (waist/hip ratio) was assessed in a population of 11,825 women, aged 40-73 years, presenting for routine breast cancer screening (the DOM project in Utrecht) in the period 1984 to 1986. Waist/hip ratio increased with increasing Quetelet's index and age. Postmenopausal women did not have higher waist/hip ratios compared to premenopausal women after adjustment for Quetelet's index and age. In pre- and postmenopausal women, waist/hip ratio increased with increasing number of cigarettes smoked per day (while Quetelet's index decreased) and a positive linear relationship was found between parity and waist/hip ratio (also after adjustment for Quetelet's index and age). Age at menarche was strongly inversely related to Quetelet's index but was not related to waist/hip ratio. In postmenopausal women, waist/hip ratio was lower in women who reported to use oestrogens for menopausal complaints in comparison with similar women who did not, but this difference disappeared after adjustment for age and degree of obesity. This study emphasizes the role of some variables that are associated with fat distribution and are potential confounders of risk estimates of abdominal obesity.