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

journal contribution
posted on 01.07.2008, 00:00 authored by Crystal Man Ying Lee, Rachel HuxleyRachel Huxley, Rachel P Wildman, Mark Woodward
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.

History

Journal

Journal of Clinical Epidemiology

Volume

61

Issue

7

Pagination

646 - 653

Publisher

Elsevier

Location

Philadelphia, Pa.

ISSN

0895-4356

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2008, Elsevier