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. 2009 May;20(3):361-6.
doi: 10.1097/EDE.0b013e31819f38f1.

Waist-height ratio as a predictor of coronary heart disease among women

John H Page  1 , Kathryn M Rexrode, Frank Hu, Christine M Albert, Claudia U Chae, Joann E Manson
Affiliations

Waist-height ratio as a predictor of coronary heart disease among women

John H Page et al. Epidemiology. 2009 May.

Abstract

Background: It is not yet established what specific measures of obesity might be most strongly associated with risk of coronary artery disease. We compared the waist-height ratio to waist-hip ratio, waist circumference, and body mass index as predictors of subsequent coronary heart disease (CHD) in a group of predominantly postmenopausal women.

Methods: The data come from the prospective Nurses' Health Study cohort. We included 45,563 women in 1986 who were aged 40-65 years and were free of heart disease, stroke, and cancer. Waist circumference, hip circumference, height, weight, age, and other covariates were collected by questionnaire. Our primary end point was incident coronary heart disease reported up to June 2002. Areas under the receiver operating characteristic curves (AUCs) were estimated nonparametrically for each of the anthropometric measures. We estimated differences between the AUCs for weight-height ratio and the other measures, with corresponding 95% confidence intervals. We used Cox proportional hazard models to estimate the relationships with risk of CHD.

Results: Waist-height ratio, waist-hip ratio, and waist circumference were similar in predicting subsequent risk of CHD. All 3 waist-derived measures were superior to body-mass index (BMI) in predicting CHD. The unadjusted AUCs were 0.62 (95% confidence interval = 0.60-0.64) for waist-height ratio, 0.63 (0.61-0.65) for waist-hip ratio, 0.62 (0.60-0.64) for waist-circumference, and 0.57 (0.55-0.59) for BMI.

Conclusion: Waist-height ratio is comparable with waist circumference and waist-hip ratio for prediction of coronary heart disease incidence among middle-aged and older women, but superior to BMI.

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Figures

Figure 1
Figure 1
Receiver Operating Characteristic Curves of Waist Height Ratio (WHtR), Waist Circumference (WC), Waist Hip Ratio (WHR) and Body Mass Index (BMI) in utility of predicting Coronary Heart Disease within 10 years
Figure 2
Figure 2
Receiver Operating Characteristic Curves of Waist Height Ratio (WHtR), Waist Circumference (WC), Waist Hip Ratio (WHR) and Body Mass Index (BMI) in utility of predicting Coronary Heart Disease from 1986 to 2002.
Figure 3
Figure 3
Relationshipa between Waist Height Ratio in 1986 and subsequent hazard of Coronary Heart Disease among Women.
Figure 4
Figure 4
Relationshipa between Waist Circumference (cm) in 1986 and subsequent hazard of Coronary Heart Disease among Women.
Figure 5
Figure 5
Relationshipa between Waist Hip Ratio in 1986 and subsequent hazard of Coronary Heart Disease among Women.
Figure 6
Figure 6
Relationshipa between Body Mass Index (kg/m2) in 1986 and subsequent hazard of Coronary Heart Disease among Women.
See this image and copyright information in PMC

References

    1. Rimm EB, Willett WC, Hu FB, Sampson L, Colditz GA, Manson JE, Hennekens C, Stampfer MJ. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. Jama. 1998;279(5):359–64. - PubMed
    1. Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed) 1984;288(6428):1401–4. - PMC - PubMed
    1. Einstein FH, Atzmon G, Yang XM, Ma XH, Rincon M, Rudin E, Muzumdar R, Barzilai N. Differential responses of visceral and subcutaneous fat depots to nutrients. Diabetes. 2005;54(3):672–8. - PubMed
    1. Barzilai N, She L, Liu BQ, Vuguin P, Cohen P, Wang J, Rossetti L. Surgical removal of visceral fat reverses hepatic insulin resistance. Diabetes. 1999;48(1):94–8. - PubMed
    1. Bjorntorp P. Abdominal fat distribution and the metabolic syndrome. J Cardiovasc Pharmacol. 1992;20(Suppl 8):S26–8. - PubMed

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