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.
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.
Authors: N E M Jaspers; J A N Dorresteijn; Y van der Graaf; J Westerink; L J Kappelle; H M Nathoe; A Algra; F L J Visseren Journal: Int J Obes (Lond) Date: 2017-08-04 Impact factor: 5.095
Authors: Huifen Wang; Lyn M Steffen; David R Jacobs; Xia Zhou; Henry Blackburn; Alan K Berger; Kristian B Filion; Russell V Luepker Journal: Am J Epidemiol Date: 2011-01-27 Impact factor: 4.897