title: Optimal scaling of weight and waist circumference to height for adiposity and cardiovascular disease risk in individuals with spinal cord injury.
abstract: METHODS
  Observational cross-sectional study.
  
  
  OBJECTIVE
  Body mass index (BMI), measured as a ratio of weight (Wt) to the square of height (Wt/Ht(2)), waist circumference (WC) and waist-to-height ratio (WHtR) are common surrogate measures of adiposity. It is not known whether alternate scaling powers for height might improve the relationships between these measures and indices of obesity or cardiovascular disease (CVD) risk in individuals with spinal cord injury (SCI). We aimed to estimate the values of 'x' that render Wt/Ht(x) and WC/Ht(x) maximally correlated with dual energy x-ray absorptiometry (DEXA) total and abdominal body fat and Framingham Cardiovascular Risk Scores.
  
  
  METHODS
  Canadian public research institution.
  
  
  METHODS
  We studied 27 subjects with traumatic SCI. Height, Wt and body fat measurements were determined from DEXA whole-body scans. WC measurements were also obtained, and individual Framingham Risk Scores were calculated. For values of 'x' ranging from 0.0 to 4.0, in increments of 0.1, correlations between Wt/Ht(x) and WC/Ht(x) with total and abdominal body fat (kg and percentages) and Framingham Risk Scores were computed.
  
  
  RESULTS
  We found that BMI was a poor predictor of CVD risk, regardless of the scaling factor. Moreover, BMI was strongly correlated with measures of obesity, and modification of the scaling factor from the standard (Wt/Ht(2)) is not recommended. WC was strongly correlated with both CVD risk and obesity, and standard measures (WC and WHtR) are of equal predictive power.
  
  
  CONCLUSIONS
  On the basis of our findings from this sample, alterations in scaling powers may not be necessary in individuals with SCI; however, these findings should be validated in a larger cohort.
authors.affiliation: 1] School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada [2] International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: J J
authors.initials: JJ
authors.lastname: Cragg
authors.affiliation: 1] International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada [2] Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: H J C Rianne
authors.initials: HJ
authors.lastname: Ravensbergen
authors.affiliation: 1] International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada [2] British Columbia Institute of Technology (BCIT), Burnaby, British Columbia, Canada.
authors.forename: J F
authors.initials: JF
authors.lastname: Borisoff
authors.affiliation: 1] International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada [2] Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: V E
authors.initials: VE
authors.lastname: Claydon
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000328:Adult; D001827:Body Height; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013119:Spinal Cord Injuries / Q000097:blood / Q000150:complications*; D013223:Statistics as Topic; D055105:Waist Circumference
chemical_list: D008055:Lipids