The online version of this article (https://doi.org/10.1186/s12872-018-0754-z) contains supplementary material, which is available to authorized users.
Various anthropometric indices can be used to estimate obesity, and it is important to determine which one is the best in predicting the risk of coronary heart disease (CHD) and to define the optimal cut-off point for the best index.
This cross-sectional study investigated a consecutive sample of 11,247 adults, who had lived in rural areas of China and were older than 35 years of age. Eight obesity indices, including the body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI) and a body shape index (ABSI) were investigated. The risk of CHD was evaluated by the 10-year coronary event risk (Framingham risk score). Receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive ability of the obesity indices for CHD risk.
Of the whole population, 3636 (32.32%) participants had a risk score higher than 10%. Those who suffered medium or high CHD risk were more likely to have higher mean anthropometric indices, except for BMI in males. In the multivariate-adjusted logistic regression, all these anthropometric measurements were statistically associated with CHD risk in males. After adjusting for all the possible confounders, these anthropometric measurements, except for ABSI, remained as independent indicators of CHD risk in females. According to the ROC analyses, ABSI provided the largest area under the curve (AUC) value in males, and BMI showed the lowest AUC value, with AUC varying from 0.52 to 0.60. WHtR and BRI provided the largest AUC value in female, and similarly, BMI showed the lowest AUC value, with AUC varying from 0.59 to 0.70. The optimal cut-off values were as follows: WHtR (females: 0.54), BRI (females: 4.21), and ABSI (males: 0.078).
ABSI was the best anthropometric index for estimating CHD risk in males, and WHtR and BRI were the best indicators in females. Males should maintain an ABSI of less than 0.078, and females should maintain a WHtR of less than 0.54 or a BRI of less than 4.21.
Additional file 1: Health Questionnaire(2012). The questionnaire used in our study was developed for this study. (PDF 124 kb)12872_2018_754_MOESM1_ESM.pdf
Juonala M, Magnussen CG, Berenson GS, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2012;365:1876. CrossRef
Huxley R, Barzi F, Lee C, et al. Is central obesity a better discriminator of the risk of hypertension than body mass index in ethnically diverse populations? J Hypertens. 2008;26:169–77. CrossRef
Han TS, Mcneill G, Seidell JC, et al. Predicting intra-abdominal fatness from anthropometric measures: the influence of stature. Int J Obes. 1997;21:587. CrossRef
Pretheeban M, Hammond G, Bandiera S, et al. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012;13:275–86. CrossRef
Van DSB, Takken T, Prinsen EC, et al. Different anthropometric adiposity measures and their association with cardiovascular disease risk factors: a meta-analysis. Netherlands Heart Journal Monthly Journal of the Netherlands Society of Cardiology & the Netherlands Heart Foundation. 2012;20:208–18. CrossRef
Bergman RN. A better index of body adiposity. Obesity. 2012;19:1135. CrossRef
Lam BC, Lim SC, Wong MT, et al. A method comparison study to validate a novel parameter of obesity, the body adiposity index, in Chinese subjects. Obesity. 2013;21:634–9. CrossRef
Bun CY. “A body shape index” in middle-age and older Indonesian population: scaling exponents and association with incident hypertension. PLoS One. 2014;9:e85421. CrossRef
Executive summary of the Third Report of The National Cholesterol EducationProgram (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97. CrossRef
World Health Organization and International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation: World Health Organization; 2006.
Wang Z, Hao G, Wang X, Wang X, et al. Current prevalence rates of overweight, obesity, central obesity, and related cardiovascular risk factors that clustered among middle-aged population of China. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(4):354–8. PubMed
Yusuf S, Hawken S, Ôunpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Orv Hetil. 2004;147(15):675.
Kim TH, Lee SS, Ji HY, et al. The relationship between the regional abdominal adipose tissue distribution and the serum uric acid levels in people with type 2 diabetes mellitus. Diabet Metabol Syndrome. 2012;4:1–7. CrossRef
Meseri R, Ucku R, Unal B. Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults. Public Health Nutr. 2013;17:1–7.
Heitmann BL, Frederiksen P. Thigh circumference and risk of heart disease and premature death: prospective cohort study. BMJ. 2009;339(7723):704–5.
Chen BD, He CH, Ma YT, et al. Best anthropometric and atherogenic predictors of metabolic syndrome in the Chinese Han population in Xinjiang: the cardiovascular risk survey. Ann Nutr Metabol. 2014;65(4):280–8. CrossRef
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