title: Waist-to-Height Ratio Compared to Standard Obesity Measures as Predictor of Cardiometabolic Risk Factors in Asian Indians in North India.
abstract: The aim of this study was to compare the discriminatory ability of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in identifying the presence of cardiometabolic risk factors in Asian Indians.
  
  
  
  This cross-sectional study involved 509 subjects (278 males and 231 females) aged 20-60 years from New Delhi, India. Measurements included complete clinical examination, blood pressure, weight, height, WC, BMI, WHR and WHtR, fasting blood glucose, lipid profile, and fasting insulin levels. Receiver operating characteristic curve analyses were performed to compare predictive validity of various adiposity measures against the cardiometabolic risk factors (dyslipidemia, hyperinsulinemia, impaired fasting glucose, hypertension, and metabolic syndrome). The odds ratio for the presence of individual cardiometabolic risk factors in the presence of overweight, abdominal obesity, and high WHtR were calculated using logistic regression analysis.
  
  
  
  WC had the highest area under ROC for all other cardiometabolic risk factors except hyperinsulinemia in males and for dyslipidemia, metabolic syndrome and presence of at least one cardiometabolic risk factor in females. For metabolic syndrome, WC, followed by WHtR, was observed to be the better predictor than other measures of adiposity, and WHtR appeared to be the best predictor for hypertension in both genders, particularly in women.
  
  
  
  In the northern Asian Indian population with high prevalence of cardiometabolic risk factors, a combination of WC and WHtR appeared to be having better clinical utility than BMI and WHR in identifying individuals with cardiometabolic risk factors.
authors.affiliation: 1 Department of Medicine, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Naval K
authors.initials: NK
authors.lastname: Vikram
authors.affiliation: 1 Department of Medicine, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Ahmad Nawid
authors.initials: AN
authors.lastname: Latifi
authors.affiliation: 2 Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology , New Delhi, India .|3 Diabetes Foundation (India) , New Delhi, India .|4 National Diabetes, Obesity and Cholesterol Foundation (N-DOC) , New Delhi, India .
authors.forename: Anoop
authors.initials: A
authors.lastname: Misra
authors.affiliation: 5 Department of Biochemistry, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Kalpana
authors.initials: K
authors.lastname: Luthra
authors.affiliation: 1 Department of Medicine, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Surya Prakash
authors.initials: SP
authors.lastname: Bhatt
authors.affiliation: 6 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Randeep
authors.initials: R
authors.lastname: Guleria
authors.affiliation: 7 Biostatistics, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Ravindra M
authors.initials: RM
authors.lastname: Pandey
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology; D065927:Waist-Height Ratio; D049629:Waist-Hip Ratio / Q000592:standards; D055815:Young Adult
keywords: Asian Indians; cardiometabolic risk; metabolic syndrome; waist circumference; waist-to-height ratio