Waist-to-height ratio and cardiovascular risk factors in elderly individuals at high cardiovascular risk

PLoS One. 2012;7(8):e43275. doi: 10.1371/journal.pone.0043275. Epub 2012 Aug 14.

Abstract

Introduction: Several anthropometric measurements have been associated with cardiovascular disease, type-2 diabetes mellitus and other cardiovascular risk conditions, such as hypertension or metabolic syndrome. Waist-to-height-ratio has been proposed as a useful tool for assessing abdominal obesity, correcting other measurements for the height of the individual. We compared the ability of several anthropometric measurements to predict the presence of type-2 diabetes, hyperglycemia, hypertension, atherogenic dyslipidemia or metabolic syndrome.

Materials and methods: In our cross-sectional analyses we included 7447 Spanish individuals at high cardiovascular risk, men aged 55-80 years and women aged 60-80 years, from the PREDIMED study. Logistic regression models were fitted to evaluate the odds ratio of presenting each cardiovascular risk factor according to various anthropometric measures. The areas under the receiver-operating characteristic curve (AUC) were used to compare the predictive ability of these measurements.

Results: In this relatively homogeneous cohort with 48.6% of type-2 diabetic individuals, the great majority of the studied anthropometric parameters were significantly and positively associated with the cardiovascular risk factors. No association was found between BMI and body weight and diabetes mellitus. The AUCs for the waist-to-height ratio and waist circumference were significantly higher than the AUCs for BMI or weight for type-2 diabetes, hyperglycemia, atherogenic dyslipidemia and metabolic syndrome. Conversely, BMI was the strongest predictor of hypertension.

Conclusions: We concluded that measures of abdominal obesity showed higher discriminative ability for diabetes mellitus, high fasting plasma glucose, atherogenic dyslipidemia and metabolic syndrome than BMI or weight in a large cohort of elderly Mediterranean individuals at high cardiovascular risk. No significant differences were found between the predictive abilities of waist-to-height ratio and waist circumference on the metabolic disease.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anthropometry / methods
  • Body Constitution
  • Body Height*
  • Body Mass Index
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / therapy
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity, Abdominal / complications*
  • Obesity, Abdominal / diagnosis
  • Odds Ratio
  • Regression Analysis
  • Risk
  • Risk Factors
  • Spain
  • Waist Circumference*

Grant support

This study was funded, in part, by the Spanish Ministry of Health (ISCIII), PI1001407, Thematic Network G03/140, RD06/0045, FEDER (Fondo Europeo de Desarrollo Regional), and the Centre Català de la Nutrició de l’Institut d’Estudis Catalans. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. CIBERobn is an initiative of ISCIII, Spain.