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Comparative Study
. 2015 Sep;38(9):527-34.
doi: 10.1002/clc.22437. Epub 2015 Sep 7.

Conicity Index and Waist-to-Hip Ratio Are Superior Obesity Indices in Predicting 10-Year Cardiovascular Risk Among Men and Women

Nima Motamed  1 , Dhaya Perumal  2 , Farhad Zamani  1 , Hossein Ashrafi  2 , Majid Haghjoo  1 , F S Saeedian  1 , Mansooreh Maadi  1 , Haleh Akhavan-Niaki  3 , Behnam Rabiee  1 , Mohsen Asouri  4
Affiliations
Comparative Study

Conicity Index and Waist-to-Hip Ratio Are Superior Obesity Indices in Predicting 10-Year Cardiovascular Risk Among Men and Women

Nima Motamed et al. Clin Cardiol. 2015 Sep.

Abstract

Background: Central obesity has been recognized as a main risk factor for cardiovascular (CV) events. Three popular central obesity indices are waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio; abdominal volume index and conicity index are 2 recent novel obesity indices. The main aim of this study is to determine the performance of these indices to best predict 10-year CV events.

Hypothesis: Some obesity indices can be used to predict cardiovascular risk.

Methods: In total, 3199 subjects (age range, 40-79 years) were enrolled in this cross-sectional study. The American College of Cardiology/American Heart Association and Framingham risk score tools were used to estimate the 10-year CV events. Receiver operating characteristic curve analysis was used to determine the optimal discriminator(s) among the central obesity measures in the estimation of a 10-year risk of CV events ≥7.5%, ≥10%, and ≥20% separately.

Results: Among the 5 central obesity indices, conicity index showed the most discriminatory power in estimation of a 10-year CV risk. In men, based on the American College of Cardiology/American Heart Association tool, the areas under the curve (AUCs) were from 0.671 to 0.682 based on the 3 above thresholds, whereas with the Framingham tool, AUCs were from 0.651 to 0.659. In women, all AUCs were >0.7. Our results also showed WHR to be an almost comparable discriminator of CV disease risk in the Iranian study population.

Conclusion: Conicity index and WHR had a more discriminatory accuracy for 10-year CV events compared with the other obesity indices.

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Figures

Figure 1
Figure 1
A schematic diagram of the study participants. Abbreviations: ASCVD, atherosclerotic cardiovascular disease; MI, myocardial infarction.
Figure 2
Figure 2
The ROC curves for discriminatory accuracy of central obesity indexes for 10‐year risk of CV disease events using the ACC/AHA tool. The A‐C graphs are related to 10‐year risks ≥7.5%, ≥10%, and ≥20%, respectively, in men, and D‐F are related to identical outcomes in women. Abbreviations: ACC/AHA, American College of Cardiology/American Heart Association; AVI, abdominal volume index; CI, conicity index; CV, cardiovascular; ROC, receiver operating characteristic; WC, waist circumference; WHR, waist‐to‐hip ratio; WHtR, waist‐to‐height ratio.
Figure 3
Figure 3
ROC curves for discriminatory accuracy of central indexes for 10‐year risk of CV diseases events using the Framingham tool. Panels A–C are related to 10‐year risks ≥7.5%, ≥10%, and ≥20%, respectively, in men, and panels D–F are related to identical outcomes in women. Abbreviations: AVI, abdominal volume index; CI, conicity index; CV, cardiovascular; WC, waist circumference; WHR, waist‐to‐hip ratio; WHtR, waist‐to‐height ratio.
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