Is there an independent association between waist-to-hip ratio and cardiovascular risk factors in overweight and obese women?

Fereidoun Azizi, Ahmad Esmaillzadeh, Parvin Mirmiran, Elaheh Ainy
International Journal of Cardiology 2005 May 11, 101 (1): 39-46

BACKGROUND: This study was conducted to evaluate the relationship between waist-to-hip ratio (WHR) and cardiovascular risk factors in overweight and obese women and to determine a point of WHR above which the chances of having cardiovascular risk factors increased.

METHODS: In this cross-sectional study, 2892 pre- and postmenopausal women aged 20-78 years with body mass index (BMI) > or = 25 selected from among 5791 women of the Tehran Lipid and Glucose Study (TLGS) population (n = 15,005), by multistage cluster random sampling method, were included. Anthropometric indices were measured and BMI and WHR were calculated. Blood pressure was evaluated according to standard protocols. Biochemical indices were measured in the fasting state. Subjects were placed into the high-risk categories for cardiovascular disease on the basis of population-defined norms. Women were divided into quartiles based on their WHR: quartile 1: < 0.78, quartile 2: 0.78- < 0.83, quartile 3: 0.83- < 0.88, quartile 4: > or = 0.88 for premenopausal women, and quartile 1: < 0.84, quartile 2: 0.84- < 0.9, quartile 3: 0.9- < 0.94 and quartile 4: > or = 0.94 for postmenopausal women.

RESULTS: A lower proportion of pre- and postmenopausal women with BMI > or = 35 were in quartile 1 and a higher proportion in quartile 4. A significant increasing trend was observed for odds ratio of having low HDL-C, high triglyceride, high total-/HDL-cholesterol and high fasting blood sugar (FBS) with increasing WHR. Controlling for BMI and simultaneously adjusting for confounding variables had no effect on this trend. Although no significant increasing trends were seen for having high total cholesterol, LDL-cholesterol, systolic and diastolic blood pressure with quartiles of WHR in both pre- and postmenopausal women, subjects with higher quartiles of WHR still had higher chances for having high total cholesterol. In the case of postmenopausal women having of higher odds for high LDL-cholesterol and high systolic blood pressure in the fourth quartile of WHR should also be added to the high total cholesterol.

CONCLUSION: The results showed that in overweight and obese women, chances of having cardiovascular risk factors increased with WHR > or = 0.78 for premenopausal and with WHR > or = 0.84 for postmenopausal women.

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