Association Between Adiposity Indices and Cardiometabolic Risk Factors Among Adults Living in Puerto Rico

Public Health Nutr. 2011 Oct;14(10):1714-23. doi: 10.1017/S1368980011000796. Epub 2011 May 24.


Objective: To compare the general adiposity index (BMI) with abdominal obesity indices (waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR)) in order to examine the best predictor of cardiometabolic risk factors among Hispanics living in Puerto Rico.

Design: Secondary analysis of measurements taken from a representative sample of adults. Logistic regression models (prevalence odds ratios (POR)), partial Pearson's correlations (controlling for age and sex) and receiver-operating characteristic (ROC) curves were calculated between indices of obesity (BMI, WC, WHR and WHtR) and blood pressure, HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), total cholesterol (TC):HDL-C, TAG, fasting blood glucose, glycosylated Hb, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) and an aggregated measure of cardiometabolic risk.

Setting: Household study conducted between 2005 and 2007 in the San Juan Metropolitan Area in Puerto Rico.

Subjects: A representative sample of 858 non-institutionalized adults.

Results: All four obesity indices significantly correlated with the cardiometabolic risk factors. WHtR had the highest POR for high TC:HDL-C, blood pressure, hs-CRP, fibrinogen and PAI-1; WC had the highest POR for low HDL-C and high LDL-C and fasting blood glucose; WHR had the highest POR for overall cardiometabolic risk, TAG and glycosylated Hb. BMI had the lowest POR for most risk factors and smallest ROC curve for overall cardiometabolic risk.

Conclusions: The findings of the study suggest that general adiposity and abdominal adiposity are both associated with cardiometabolic risk in this population, although WC, WHR and WHtR appear to be slightly better predictors than BMI.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity*
  • Adult
  • Aged
  • Blood Pressure
  • Body Height
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / physiopathology*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nutritional Physiological Phenomena
  • Obesity / complications
  • Obesity / epidemiology*
  • Odds Ratio
  • Plasminogen Activator Inhibitor 1 / metabolism
  • Prevalence
  • Puerto Rico / epidemiology
  • Risk Factors
  • Waist Circumference
  • Waist-Hip Ratio


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Plasminogen Activator Inhibitor 1
  • C-Reactive Protein