Waist-to-height ratio and cardiovascular risk factors in elderly individuals at high cardiovascular risk.
BACKGROUND
Several anthropometric measurements have been associated with cardiovascular disease, type-2 diabetes mellitus and other cardiovascular risk conditions, such as hypertension or metabolic syndrome. Waist-to-height-ratio has been proposed as a useful tool for assessing abdominal obesity, correcting other measurements for the height of the individual. We compared the ability of several anthropometric measurements to predict the presence of type-2 diabetes, hyperglycemia, hypertension, atherogenic dyslipidemia or metabolic syndrome.


METHODS
In our cross-sectional analyses we included 7447 Spanish individuals at high cardiovascular risk, men aged 55-80 years and women aged 60-80 years, from the PREDIMED study. Logistic regression models were fitted to evaluate the odds ratio of presenting each cardiovascular risk factor according to various anthropometric measures. The areas under the receiver-operating characteristic curve (AUC) were used to compare the predictive ability of these measurements.


RESULTS
In this relatively homogeneous cohort with 48.6% of type-2 diabetic individuals, the great majority of the studied anthropometric parameters were significantly and positively associated with the cardiovascular risk factors. No association was found between BMI and body weight and diabetes mellitus. The AUCs for the waist-to-height ratio and waist circumference were significantly higher than the AUCs for BMI or weight for type-2 diabetes, hyperglycemia, atherogenic dyslipidemia and metabolic syndrome. Conversely, BMI was the strongest predictor of hypertension.


CONCLUSIONS
We concluded that measures of abdominal obesity showed higher discriminative ability for diabetes mellitus, high fasting plasma glucose, atherogenic dyslipidemia and metabolic syndrome than BMI or weight in a large cohort of elderly Mediterranean individuals at high cardiovascular risk. No significant differences were found between the predictive abilities of waist-to-height ratio and waist circumference on the metabolic disease.
Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.
Marta
M
Guasch-Ferré
Mònica
M
Bulló
Miguel Ángel
MÁ
Martínez-González
Dolores
D
Corella
Ramon
R
Estruch
María-Isabel
MI
Covas
Fernando
F
Arós
Julia
J
Wärnberg
Miquel
M
Fiol
José
J
Lapetra
Miguel Ángel
MÁ
Muñoz
Lluís
L
Serra-Majem
Xavier
X
Pintó
Nancy
N
Babio
Andrés
A
Díaz-López
Jordi
J
Salas-Salvadó
D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D001824:Body Constitution; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000628:therapy; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000175:diagnosis; D016017:Odds Ratio; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D013030:Spain; D055105:Waist Circumference