Optimal waist:height ratio cut-off point for cardiometabolic risk factors in Turkish adults

Division of Endocrinology and Metabolism, Department of Medicine, Private Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey.
Public Health Nutrition (Impact Factor: 2.68). 09/2009; 13(4):488-95. DOI: 10.1017/S1368980009991637
Source: PubMed


To identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.
Cross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score >or=2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 - specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity - 1).
Turkey, 2003.
Adults (1121 women and 571 men) aged 18 years and over were examined.
Analysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0.55 and 0.60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0.63 and 0.81, the specificities were between 0.42 and 0.71 and the accuracies were between 0.65 and 0.73, for men and women. The cut-off point of 0.59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR >or= 0.59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0.59, except for diabetes in men.
We show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0.59 in Turkish adults.

Download full-text


Available from: Ahmet Selçuk Can, Sep 30, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: The determination of the approximately truest value in height measurement is important in many fields, but it is difficult to perform true measurements, especially in the elderly individuals. We planned to investigate the following items in geriatric Turkish population: to calculate the decrease in height with advancing age by using the standing height measurement and estimated height derived from the knee height; to evaluate the significance of difference between the two measurement methods in the calculation of body mass index (BMI) and waist/height ratio (WHtR); to determine the cut-off value of WHtR according to estimated height in elderly individuals. We studied 551 cases aged between 19 and 97 years. Knee height was measured using a sliding caliper in a sitting position. Linear regression analysis was carried out to derive predictive equations for the estimation of stature with adults (≤ 50 years of age) according to the gender. This equation was then used to estimate height among elderly subjects. Of the cases, 60.3% were <60 years (mean: 48.75 ± 7.50); 39.7% of the cases were >60 years (mean: 69.51 ± 7.12). Estimated BMI (EBMI) measurements in the females and males >60 years were in average 1.23 kg/m(2) and 0.92 kg/m(2) higher than their real BMIs, respectively. EBMI measurements in the females <60 years were 0.32 kg/m(2) higher than their real BMIs (p<0.01). There is a statistically significant difference between WHtR in the females of both age groups, and in the males >60 years, as compared to our estimated WHtR (EWHtR) measurements (p<0.01). The cut-off point of WHtR was 0.61 and 0.58 in the female and male cases of >60 years in our study, respectively. WHtR seemed to be a better anthropometric index that could predict most cardiometabolic risk factors in our study. EWHtR emerged to be a better cardiometabolic risk index especially in the elderly group.
    No preview · Article · Dec 2010 · Archives of gerontology and geriatrics
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to investigate the influence of apoE genetic polymorphism on serum lipid changes in a community-based elderly population in China in an 8-year period, in which 746 individual, aged 65.29±6.85 years (mean±standard deviation (SD)) were enrolled and serum lipid parameters were checked at baseline. After 8 years, serum lipids as well as apoE genotypes were measured. The frequencies of apoE allele were 9.4%, 81.7%, and 8.9% for ɛ2, ɛ3 and ɛ4, respectively. After the population was divided into 3 groups by different apoE allele carriers, the apoE allele carriers for ɛ2, ɛ3 and ɛ4 were 121 (16.2%), 513 (68.8%) and 112 (15.0%), respectively. Levels of total cholesterol (TC) and low density lipoprotein (LDL) in ɛ2 carriers were lower comparing with that of ɛ3 allele carriers at baseline. 8 years later, TC and high density lipoprotein (HDL) elevated and LDL decreased with aging in this population (p<0.01). The changes of TC levels were smaller in ɛ2 allele carriers as compared to that of ɛ3 allele carriers. The difference was still statistically significant after controlling for age, sex, smoking status, drinking habit, body mass index (BMI) and baseline TC level. The same trend of changes was noted for LDL between ɛ2 and ɛ3 allele carriers. However, no significant differences were noted between ɛ4 and ɛ3 allele carriers on lipid changes. This community-based study shows that ɛ2 allele is helpful on lipid changes. The effect of ɛ4 allele on lipid change is not strong in this elderly population. Genetic and environmental factors maybe co-operate on lipid metabolism in elderly persons.
    No preview · Article · Dec 2011 · Archives of gerontology and geriatrics
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study examined the associations of anthropometric measures of obesity with high sensitivity C-reactive protein (hs-CRP) levels in Turkish immigrants with type 2 diabetes (T2D) living in the Netherlands. A total of 110 participants, physician-diagnosed with T2D, aged 30 years and older were recruited from multiple sources from The Hague, Netherlands. Serum hs-CRP levels were measured with immunoturbidimetric assay. Glycated hemoglobin (A1C) was determined by high-pressure liquid chromatography. Measures of obesity: body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were determined. Statistical analysis included descriptive statistics, Pearson’s correlations and multiple linear regressions (MLR) stratified by gender. Hs-CRP was log transformed to achieve normality. Subjects with hs-CRP levels >10 mg/L (n = 17) were excluded from the analysis. Females had a higher BMI (p = 0.007), HC (p < 0.001), and WHtR (p = 0.011) as compared to males. Conversely, males had a higher weight (p = 0.007), and WHR (p < 0.001) than females. MLR showed that after controlling for covariates, log hs-CRP was positively associated with BMI (B = 0.039, SE = 0.019, β = 0.287, p < 0.05), WC (B = 0.025, SE = 0.011, β = 0.332, p < 0.05) and WHtR (B = 4.015, SE = 1.464, β = 0.376, p < 0.01) in females only. Gender-specific associations between obesity measures and hs-CRP level need to be further investigated in the Turkish immigrant population. Hs-CRP assessment may be added as a standard of care for T2D treatment within this population.
    Full-text · Article · Jul 2012 · Ageing International
Show more