Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men

A Esmaillzadeh, P Mirmiran, F Azizi
International Journal of Obesity and related Metabolic Disorders 2004, 28 (10): 1325-32

BACKGROUND: It is essential to identify the best anthropometric index in any population to predict chronic disease risk.

OBJECTIVE: To compare the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) to predict cardiovascular risk factors in an urban adult population of Tehranian men.

DESIGN: Population-based cross-sectional study.

SUBJECTS: A representative sample of 4,449 men aged 18-74 y, participants of the Tehran Lipid and Glucose Study

METHODS: Demographic data were collected; anthropometric indices and blood pressure were measured according to standard protocol. In the 18-34 y age category, cutoff points for BMI, WHpR, WHtR and WC were 24 kg/m(2), 0.86, 0.47 and 81 cm, respectively. In the 35-54 y age category these cut points were 26 kg/m(2), 0.91, 0.52 and 89 cm, and in the 55-74 y age category 26 kg/m(2), 0.95, 0.54 and 91 cm, respectively. Hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose > or =126 mg/dl or 2hPG > or =200 mg/dl and dyslipidemia based on ATP III. The presence of 'at least one risk factor' from the three major cardiovascular risk factors (hypertension, dyslipidemia and diabetes) was also evaluated.

RESULTS: Mean age of men was 41.8+/-15.4 y. Mean BMI, WHpR, WC and WHtR for subjects were 25.6+/-4.2 kg/m(2), 0.91+/-0.07, 87.7+/-11.7 cm and 0.51+/-0.02, respectively. Dyslipidemia and 'at least one risk factor' are more prevalent risk categories. Although all anthropometric indicators had a significant association to cardiovascular risk factors, WHpR had the highest correlation coefficients compared to other anthropometric measures. For all risk factors in all age categories, the highest odds ratios were pertained to WHpR. Of the four individual indicators, WHpR had the highest sensitivity, specificity and accuracy to predict cardiovascular risk factors. Cutoff points for WHpR were seen to have a higher percentage of correct prediction than BMI, WC and WHtR in all age categories.

CONCLUSION: It is concluded that WHpR is a better predictor for cardiovascular risk factors than BMI, WC and WHtR in Tehranian adult men.

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