Is Waist to Height Ratio Better than Other Indices of Obesity in Determining Cardiovascular Risk?

Abstract

Background: The indices of obesity (measured by Body Mass Index, waist circumference, and weight-to-height ratio) have been observed to be strongly associated with cardiovascular risk. Body mass index (BMI) is a measure of general obesity while waist circumference (WC) and waist-to-height ratio (WHtR) are used to measure central obesity, with the latter suggested to be the indicator for the prediction of cardiovascular risks. This study aimed to determine the advantage of WHtR for cardiovascular risk over the use of other indices of obesity. Methods: The study was a cross-sectional descriptive design carried out among 441 participants at the Metabolic Research Laboratory LTH Ogbomoso excluding pregnant or breastfeeding mothers, thyroid disease, those diagnosed with hypertension, diabetes, or hyperlipidemia, those on blood-pressure, blood-glucose or lipid-lowering medications; those on weight-control medications or supplements. A structured self-administer questionnaire was distributed to obtain socio-demographic data of participants. Physical examination was done with anthropometry measurements. Fasting blood samples were obtained for blood glucose and lipid profiles. Data analysis was done using SPSS version 21. Results: The study included 441 subjects with male to female ratio of 1:1.47 mean age of 37.92±11.80 and 34.72±12.16 respectively. Blood pressure, pulse rate, height and other obesity indices except waist circumference were all statistically significantly higher in the males than in the females p <0.05. There was a statistically significant difference in the BMI between the sexes for all categories with the majority of female subjects having abnormal BMI and waist circumference. There was a statistically significant relationship between all the obesity indices (BMI, WHtR & WC) and the cardiovascular risk factors excluding TG and HDLC P <0.05. Conclusion: It was observed that all indices of obesity measured in this study were sensitive and significant in determining cardiovascular risk. It could be concluded that WHtR does not have a special or greater advantage over BMI and WC as all indices showed a significant association with cardiovascular risks. Also, the level of statistical significance suggested  that either of these obesity indices could be used independently as a predictor of cardiovascular risk.