Comparison of body mass index, waist circumference, and waist-to-height ratio for predicting the clustering of cardiometabolic risk factors by age in Japanese workers—Japan Epidemiology Collaboration on Occupational Health study

Ai Hori, Akiko Nanri, Nobuaki Sakamoto, Keisuke Kuwahara, Satsue Nagahama, Noritada Kato, Kenji Fukasawa, Kengo Nakamoto, Mayumi Ohtsu, Aki Matsui, Takeshi Kochi, Masafumi Eguchi, Teppei Imai, Akiko Nishihara, Kentaro Tomita, Taizo Murakami, Chii Shimizu, Makiko Shimizu, Toshiaki Miyamoto, Akihiko Uehara, Makoto Yamamoto, Tohru Nakagawa, Shuichiro Yamamoto, Toru Honda, Hiroko Okazaki, Naoko Sasaki, Kayo Kurotani, Ngoc Minh Pham, Isamu Kabe, Tetsuya Mizoue, Tomofumi Sone, Seitaro Dohi
Circulation Journal: Official Journal of the Japanese Circulation Society 2014, 78 (5): 1160-8

BACKGROUND: Waist-to-height ratio (WHtR) has been suggested as a better screening tool than body mass index (BMI) and waist circumference (WC) for assessing cardiometabolic risk. However, most previous studies did not consider age.

METHODS AND RESULTS: Participants were 45,618 men and 8,092 women aged 15-84 years who received periodic health checkups in 9 companies in Japan. Clustering of cardiometabolic risk factors was defined by the existence of 2 or more of high blood pressure, hyperglycemia, and dyslipidemia. In both men and women, unadjusted area under the curve (AUC) of the receiver-operating characteristic curve for WHtR in detecting the clustering of cardiometabolic risk factors was significantly higher than that for either BMI or WC; the AUCs for WHtR, BMI, and WC, respectively, were 0.734, 0.705, and 0.717 in men and 0.782, 0.762, and 0.755 in women. After adjustment for age, however, such differences were not observed; the corresponding values were 0.702, 0.701, and 0.696 in men. In women, the age-adjusted AUC for BMI was slightly higher than for other indices (WHtR, 0.721; BMI, 0.726; WC, 0.707).

CONCLUSIONS: The screening performance of WHtR for detecting the clustering cardiometabolic risk factors was not superior to that of BMI.

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