title: Race/ethnic comparisons of waist-to-height ratio for cardiometabolic screening: The study of women's health across the nation.
abstract: OBJECTIVE
  To compare the performance of waist-to-height ratio as a screening tool for cardiometabolic conditions - hypertension, prediabetes/diabetes, dyslipidemia, and subclinical inflammation - in 5 race/ethnic groups of mid-life women.
  
  
  METHODS
  Waist-to-height ratio and 4 cardiometabolic conditions were assessed in 3033 premenopausal midlife women (249 Hispanic, 226 Chinese, 262 Japanese, 1435 European-American, and 861 African American). The areas under the receiver operating characteristic curve (AUROC) were compared across the five race/ethnic groups using waist-to-height ratio to determine the likelihood of the four cardiometabolic conditions.
  
  
  RESULTS
  The performance of waist-to-height ratio to detect one or more cardiometabolic conditions was comparable among all race/ethnic groups (AUROC > 0.60, p = 0.252), and was good/fair (AUROC > 0.60) when hypertension, prediabetes/diabetes, dyslipidemia, or subclinical inflammation were analyzed separately. The performance of waist-to-height ratio of 0.50 was skewed towards higher specificity among groups with low prevalence of cardiometabolic conditions and lower median waist-to-height ratio, and towards higher sensitivity among groups with high prevalence of cardiometabolic conditions and higher median waist-to-height ratio.
  
  
  CONCLUSIONS
  Waist-to-height ratio can be used for community-based screening of mid-life women who may need secondary prevention for cardiometabolic conditions. A simple public health message: "Keep your waist to less than half of your height" applies to midlife women.
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.|Department of Medicine, Rush University Medical Center, Chicago, IL.
authors: Rasa
authors: R
authors: Kazlauskaite
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.
authors: Elizabeth F
authors: EF
authors: Avery-Mamer
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.
authors: Hong
authors: H
authors: Li
authors: Department of Medicine, Rush University Medical Center, Chicago, IL.|Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, IL.
authors: Chandra P
authors: CP
authors: Chataut
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.
authors: Imke
authors: I
authors: Janssen
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.
authors: Lynda H
authors: LH
authors: Powell
authors: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.|Department of Psychiatry, Rush University Medical Center, Chicago, IL.
authors: Howard M
authors: HM
authors: Kravitz
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D065927:Waist-Height Ratio; D016387:Women's Health
keywords: anthropometry; metabolic syndrome; middle-aged; minority groups; waist circumference