title: Waist-to-height ratio is a highly sensitive index for the metabolic syndrome in a Mediterranean population.
abstract: BACKGROUND
  The waist-to-height ratio (WHtR) is a potentially more reliable anthropometric index, particularly for populations of lower height. Performance of the WHtR versus body mass index (BMI) and enlarged waist circumference (WC) in the assessment of the metabolic syndrome was tested in nonobese males and females in a high-risk Italian population.
  
  
  METHODS
  WHtR, BMI, and WC were determined in 552 males and 552 females, together with the evaluation of associated metabolic syndrome variables (hypertension, hyperglycemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol [HDL-C]).
  
  
  RESULTS
  WHtR > or = 0.5, the most frequently suggested threshold value, when added to any two nonanthropometric variables, gave a sensitivity for the identification of a metabolic syndrome of, respectively, 92.0% for males and 87.4% for females. Sensitivities for elevated WC (American Heart Association [AHA] criteria) and BMI > or = 25 proved lower. Areas under the receiver operating characteristic (ROC) curves for the different anthropometric indices confirmed that a WHtR > or = 0.5 provides a satisfactory balance between sensitivity and specificity.
  
  
  CONCLUSIONS
  WHtR > or = 0.5 may be the most effective anthropometric index for screening high-risk patients in the diagnosis of metabolic syndrome, with the advantage of the opportunity of direct comparisons with other populations.
authors.affiliation: University Center for Dyslipidemias, Niguarda Hospital, Milano, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Mombelli
authors.forename: Anna M
authors.initials: AM
authors.lastname: Zanaboni
authors.forename: Sabrina
authors.initials: S
authors.lastname: Gaito
authors.forename: Cesare R
authors.initials: CR
authors.lastname: Sirtori
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D008055:Lipids