title: Waist to height ratio: a better anthropometric marker of diabetes and cardio-metabolic risks in South Asian adults.
abstract: OBJECTIVE
  Obesity associated metabolic diseases have reached epidemic levels in many South Asian countries. Conventional anthropometric indices have poor sensitivity and specificity for detecting people with increased metabolic risks. The aim of this study was to investigate and compare WHtR (Waist to Height Ratio) as a marker of diabetes and cardio-metabolic risks with existing classical anthropometric indices such as; Body Mass Index (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) in a large sub-population of ethnic South Asians.
  
  
  METHODS
  A total of 5000 subjects recruited from a nationally representative community-based sample using multi-stage random cluster-sampling method. Anthropometric, biochemical and clinical parameters were measured. Receiver-operating characteristic (ROC) curves were performed and area under the curve (AUC) was calculated for each anthropometric index.
  
  
  RESULTS
  Sample size was 4485. The mean WHtR in all adults was 0.496 (±0.077), males (0.477±0.065) had a significant lower WHtR than females (0.508±0.081) (p<0.001). WHtR had the highest correlation with metabolic parameters. In all adults, males and females the AUC of WHtR was significantly higher than that of BMI, WC and WHR in diabetes mellitus, pre-diabetes, hypertension, metabolic syndrome and hypercholesterolemia. Mean age, fasting blood glucose, 2-h post prandial blood Glucose, total cholesterol, LDL cholesterol, triglycerides, systolic blood pressure and diastolic blood pressure were all significantly higher among all adults, males and females with WHtR≥0.5.
  
  
  CONCLUSIONS
  WHtR is a simple and effective anthropometric index to identify obesity associated metabolic risks among Sri Lankan adults.
authors.affiliation: Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.
authors.forename: R
authors.initials: R
authors.lastname: Jayawardana
authors.forename: P
authors.initials: P
authors.lastname: Ranasinghe
authors.forename: M H R
authors.initials: MH
authors.lastname: Sheriff
authors.forename: D R
authors.initials: DR
authors.lastname: Matthews
authors.forename: P
authors.initials: P
authors.lastname: Katulanda
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D019540:Area Under Curve; D044466:Asian People; D015415:Biomarkers; D001827:Body Height; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011236:Prediabetic State; D012307:Risk Factors; D013188:Sri Lanka / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D015415:Biomarkers