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Review
. 2008 Jul;61(7):646-53.
doi: 10.1016/j.jclinepi.2007.08.012. Epub 2008 Mar 21.

Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis

Crystal Man Ying Lee  1 , Rachel R Huxley, Rachel P Wildman, Mark Woodward
Affiliations
Review

Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis

Crystal Man Ying Lee et al. J Clin Epidemiol. 2008 Jul.

Abstract

Objective: To determine which simple index of overweight and obesity is the best discriminator of cardiovascular risk factors.

Study design and setting: This is a meta-analysis of published literature. MEDLINE was searched. Studies that used receiver-operating characteristics (ROC) curve analysis and published area under the ROC curves (AUC) for overweight and obesity indices with hypertension, type-2 diabetes, and/or dyslipidemia were included. The AUC for each of the four indices, with each risk factor, was pooled using a random-effects model; male and female data were analyzed separately.

Results: Ten studies met the inclusion criteria. Body mass index (BMI) was the poorest discriminator for cardiovascular risk factors. Waist-to-height ratio (WHtR) was the best discriminator for hypertension, diabetes, and dyslipidemia in both sexes; its pooled AUC (95% confidence intervals) ranged from 0.67 (0.64, 0.69) to 0.73 (0.70, 0.75) and from 0.68 (0.63, 0.72) to 0.76 (0.70, 0.81) in males and females, respectively.

Conclusion: Statistical evidence supports the superiority of measures of centralized obesity, especially WHtR, over BMI, for detecting cardiovascular risk factors in both men and women.

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