Abdominal obesity and coronary heart disease in Thai men.
OBJECTIVE
To determine the association of four simple anthropometric indices with coronary heart disease (CHD) in Thai men, and to determine the optimal cut-off points for each index in the prediction of CHD.


METHODS
This is a cohort study with 17 years of follow-up. A total of 2536 male employees from the Electricity Generating Authority of Thailand 35 to 59 years of age at baseline were included in the study. Height, weight, waist circumference, and hip circumference were measured to generate BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Cox regression models were used to estimate hazard ratios by thirds of each index. Receiver operating characteristic curves were used to assess discrimination of CHD.


RESULTS
WHtR was most strongly associated with CHD events in Thai men. The age-adjusted hazard ratio for those in the highest, compared with the lowest, third was 2.89 (1.37, 6.11). Although WHtR had the largest area under the receiver operating characteristic curve (AUC) with the optimal cut-off estimated to be 0.51 (sensitivity, 55%; specificity, 61%), no statistically significant difference (p>0.10) was found between the AUC for WHtR and that for the other three indices.


CONCLUSIONS
WHtR is, marginally, the best of the four indices considered to predict CHD events in Thai men.
Aekplakorn
Wichai
W
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
Pakpeankitwatana
Varapat
V
Lee
Crystal M Y
CM
Woodward
Mark
M
Barzi
Federica
F
Yamwong
Sukit
S
Unkurapinun
Nongnuj
N
Sritara
Piyamitr
P
D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009765:Obesity / Q000150:complications*; D016016:Proportional Hazards Models; D013785:Thailand; D049629:Waist-Hip Ratio