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

Crystal Man Ying Lee, Rachel R. Huxley, Rachel P. Wildman, Mark Woodward

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)646-653
Number of pages8
JournalJournal of Clinical Epidemiology
Volume61
Issue number7
DOIs
StatePublished - Jul 2008
Externally publishedYes

Fingerprint

Abdominal Obesity
ROC Curve
Meta-Analysis
Body Mass Index
Obesity
Dyslipidemias
Area Under Curve
Hypertension
MEDLINE
Type 2 Diabetes Mellitus
Confidence Intervals
Waist-Height Ratio

Keywords

  • Body mass index
  • Cardiovascular risk factors
  • Meta-analysis
  • Obesity
  • ROC curve
  • Waist-to-height ratio

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI : a meta-analysis. / Lee, Crystal Man Ying; Huxley, Rachel R.; Wildman, Rachel P.; Woodward, Mark.

In: Journal of Clinical Epidemiology, Vol. 61, No. 7, 07.2008, p. 646-653.

Research output: Contribution to journalArticle

Lee, Crystal Man Ying ; Huxley, Rachel R. ; Wildman, Rachel P. ; Woodward, Mark. / Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI : a meta-analysis. In: Journal of Clinical Epidemiology. 2008 ; Vol. 61, No. 7. pp. 646-653.
@article{47108c10e2724555bcb9909e302f61d5,
title = "Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis",
abstract = "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.",
keywords = "Body mass index, Cardiovascular risk factors, Meta-analysis, Obesity, ROC curve, Waist-to-height ratio",
author = "Lee, {Crystal Man Ying} and Huxley, {Rachel R.} and Wildman, {Rachel P.} and Mark Woodward",
year = "2008",
month = "7",
doi = "10.1016/j.jclinepi.2007.08.012",
language = "English (US)",
volume = "61",
pages = "646--653",
journal = "Journal of Clinical Epidemiology",
issn = "0895-4356",
publisher = "Elsevier USA",
number = "7",

}

TY - JOUR

T1 - Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI

T2 - a meta-analysis

AU - Lee, Crystal Man Ying

AU - Huxley, Rachel R.

AU - Wildman, Rachel P.

AU - Woodward, Mark

PY - 2008/7

Y1 - 2008/7

N2 - 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.

AB - 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.

KW - Body mass index

KW - Cardiovascular risk factors

KW - Meta-analysis

KW - Obesity

KW - ROC curve

KW - Waist-to-height ratio

UR - http://www.scopus.com/inward/record.url?scp=44649092702&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44649092702&partnerID=8YFLogxK

U2 - 10.1016/j.jclinepi.2007.08.012

DO - 10.1016/j.jclinepi.2007.08.012

M3 - Article

C2 - 18359190

AN - SCOPUS:44649092702

VL - 61

SP - 646

EP - 653

JO - Journal of Clinical Epidemiology

JF - Journal of Clinical Epidemiology

SN - 0895-4356

IS - 7

ER -