Simple anthropometric indices in relation to cardiovascular risk factors in Chinese type 2 diabetic patients

Department of Endocrinology, Union Hospital, Tongji Medical School, Huazhong Technology University, Wuhan 430022, Hubei, PR China.
The Chinese journal of physiology (Impact Factor: 1.16). 06/2007; 50(3):135-42.
Source: PubMed


To determine which is the best anthropometric index among body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) in type 2 diabetic patients, we examined the relationship between these indices and cardiovascular risk factors using partial correlation analysis, chi-square test, logistic regression analysis and Receiver Operator Characteristic (ROC) curves. Partial correlation analysis showed that among the 4 obesity indices, WHtR had the highest r values for all the cardiovascular risk factors in both sexes, followed by WC. Chi-square analysis which revealed that an increased WHtR was more strongly associated with hypertension, hypertriglyceridemia (high TG) and low high-density lipoprotein cholesterol (HDL-C) than the other indices. Logistic regression analysis showed that, after controlling for age, the hypertension, high TG and low HDL-C odds ratios of WHtR > or = 0.5 were 2.56 (95% CI: 1.24, 5.29), 2.87 (95% CI: 1.43, 5.78), 2.59 (95% CI: 1.03, 6.59) in men and 3.75 (95% CI: 1.75, 8.05), 3.21 (95% CI: 1.52, 6.79), 3.62 (95% CI: 1.43, 9.21) in women, respectively. In ROC analysis, the areas under curve of WHtR were the largest for at least one risk factor in both men and women. These results indicated that WHtR had a higher correlation with cardiovascular risk factors than WC, WHR or BMI in newly diagnosed type 2 diabetes. We proposed the measurement of WHtR as a screening tool for cardiovascular risk factors in this population.

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    • "Gelber et al. [28] found WHtR had the strongest relation in association with incidence of CAD. In another study, Hong-Yan et al. [29] mentioned that waist to height ratio was the only anthrompometric index which had consistent association with cardiovascular risk factors. Schneider et al. [11] showed that the WHtR or WC may predict cardiovascular risk better than BMI or waist hip ratio (WHR), even though the differences are small. "
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    ABSTRACT: To determine whether waist-to-height ratio correlates with coronary artery disease (CAD) severity better, than the body mass index (BMI) as assessed by coronary angiography in Bangladeshi population. This cross sectional study was done on patients in Department of Cardiology in DMCH and those referred in the cath-lab of the Department of Cardiology for CAG during November 2009 to October 2010 involving 120 patients. They were divided into group-A (with coronary score >=7) and group-B (coronary score <7) depending on Gensisni score.Result: There were no statistically significant difference regarding the distribution of age, sex and clinical diagnosis and parameters between the two groups. The mean age of patients was 51.7 +/- 8.2 years and 48.8 +/- 9.1 years in Group A and Group B respectively with a male predominance in both the groups. Patients in group A had higher BMI >=25 and waist to height ratio (>=0.55) than Group B which showed a statistically significant association (p < 0.001). Though a significant positive correlation (r = 0.296, p = 0.006) was observed between BMI and Coronary artery disease score in group A patients, scenario was reverse fro group B (r = 0.076, p = 0.659). The statement was also true for Waist-to-height ratio and Waist-to-height ratio with BMI. Multivariate analysis also yeilded that a patient with BMI >=25 kg/m2 and waist-to height ratio of >=0.55 are 3.06 times and 6.77 times, more likely to develop significant coronary artery disease respectively. The waist-to-height ratio showed better correlation with the severity of coronary artery disease than the BMI.
    BMC Research Notes 04/2014; 7(1):246. DOI:10.1186/1756-0500-7-246
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    ABSTRACT: Antecedentes: Medidas antropométricas de adiposidad como índice de masa corporal (IMC), circunferencia de cintura (CC), razón cintura-cadera (RCC) y razón cintura-estatura (RCE) son conocidas por estar asociadas a factores de riesgo metabólico. Sin embargo, es controversial cual de ellas es mejor para predecir riesgo cardiovascular y mortalidad. Método: En este estudio de cohorte prospectivo con una muestra ponderada de 6714 hombres y 6340 mujeres, examinamos la relación entre índices antropométricos de adiposidad, factores de riesgo cardiovascular y mortalidad. Calculamos el área bajo la curva ROC (Receiving Operating Characteristic) evaluando el desempeño de cada índice para detectar hipertensión, diabetes o dislipidemia. El riesgo relativo de mortalidad con intervalos de confianza al 95% (IC95%) fue calculado utilizando regresión logística controlando por edad y factores de riesgo. Resultados: En hombres, las áreas bajo la curva ROC para detectar uno o más factores de riesgo fueron: IMC 0.75 (0.74-0.77), CC 0.85 (0.84-0.86), RCC 0.80 (0.79-0.81) y RCE 0.90 (0.89-0.91). En mujeres esas áreas fueron 0,72 (0,71-0,74), 0,77 (0,76-0,79), 0,65 (0,63-0,66) y 0,81 (0,80-0,82) respectivamente. Durante 8 años de seguimiento (670 muertes, 362 hombres), el riesgo multivariado de mortalidad para IMC, CC, RCC y RCE fue en hombres 0,81 (0,58-1,10), 1,27 (0,93-1,74), 0,89 (0,66-1,21) y 2,37 (1,61-3,49) respectivamente. En mujeres, el riesgo para IMC, CC, RCC, RCE fue 0,95 (0,70-1,27), 1,35 (1,00-1,85), 1,54 (1,17-2,16), y 1,56 (1,13-2,26) respectivamente. Conclusiones: El ajuste de la CC por la estatura permite predecir con mayor precisión factores de riesgo cardiovascular y mortalidad. Se propone un nomograma para adultos chilenos. Esta investigación fue financiada por un Grant de Fundación Araucaria, con sede en San Diego, California. Elard Koch es apoyado parcialmente por beca doctoral MECESUP UCH-0219, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile.
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