title: Accuracy of anthropometric indicators of obesity to predict cardiovascular risk.
abstract: BACKGROUND
  Obesity is associated with various cardiovascular risk factors. The body mass index (BMI) is the standard measure of overweight and obesity. However, more recently, waist to hip ratio (WHR) or waist circumference (WC) as more sensitive measures for visceral obesity have been proposed to be more indicative of cardiovascular risk.
  
  
  OBJECTIVE
  This study was performed to test the predictive value of anthropometric parameters for the presence of several cardiovascular risk conditions.
  
  
  METHODS
  The DETECT (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment) study is a cross-sectional, clinical-epidemiological study.
  
  
  METHODS
  We studied 5377 unselected subjects (2016 men, 3361 women) without arteriosclerotic disease, aged 20-79 yr, from the DETECT laboratory sample.
  
  
  METHODS
  This study was conducted by primary care physicians.
  
  
  METHODS
  We measured anthropometric parameters and assessed cardiovascular risk by clinical examination, patient history, and a standardized laboratory program.
  
  
  METHODS
  We assessed the associations of BMI, WC, hip circumference, WHR, and waist to height ratio (WHtR) to cardiovascular risk by calculating the area under the receiver-operating characteristic curve and adjusted odds ratios for metabolic syndrome, dyslipidemia, and type 2 diabetes.
  
  
  RESULTS
  The area under the receiver-operating characteristic curve for WHtR was significantly higher than for all other anthropometric parameters with respect to all risk conditions in women and to dyslipidemia and type 2 diabetes in men. The odds ratios for the presence of risk conditions with 1 sd increase of each anthropometric parameter were highest for WHtR or WC.
  
  
  CONCLUSIONS
  There are some indications that WHtR or WC may predict prevalent cardiovascular risk better than BMI or WHR, even though the differences are small.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technical University, Dresden, Germany. schneider@mpipsykl.mpg.de
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Schneider
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
authors.forename: Jens
authors.initials: J
authors.lastname: Klotsche
authors.forename: Steffen
authors.initials: S
authors.lastname: Böhler
authors.forename: Hendrik
authors.initials: H
authors.lastname: Lehnert
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Zeiher
authors.forename: Winfried
authors.initials: W
authors.lastname: März
authors.forename: David
authors.initials: D
authors.lastname: Pittrow
authors.forename: Günter K
authors.initials: GK
authors.lastname: Stalla
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D049629:Waist-Hip Ratio