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Nutr Metab Cardiovasc Dis. 2014 Aug;24(8):900-7. doi: 10.1016/j.numecd.2014.02.005. Epub 2014 Feb 22.

Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults.

Author information

  • 1Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Private Bag X6001, 2520, South Africa.
  • 2Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, United Kingdom.
  • 3Centre of Excellence for Nutrition (CEN), Faculty of Health Sciences, North-West University, South Africa.
  • 4Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences, North-West University, South Africa.
  • 5Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Private Bag X6001, 2520, South Africa. Electronic address: Alta.Schutte@nwu.ac.za.

Abstract

BACKGROUND AND AIMS:

Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD risk.

METHODS AND RESULTS:

Black South Africans (577 men, 942 women, aged >30years) were recruited by random household selection from four North West Province communities. Demographic and anthropometric measures were taken. Recommended diagnostic thresholds (WC > 80 cm for women, >94 cm for men; WHtR > 0.5) were evaluated to predict blood pressure, fasting blood glucose, lipids, and glycated haemoglobin measured at baseline and 5 year follow up. Women were significantly more overweight than men at baseline (mean body mass index (BMI) women 27.3 ± 7.4 kg/m(2), men 20.9 ± 4.3 kg/m(2)); median WC women 81.9 cm (interquartile range 61-103), men 74.7 cm (63-87 cm), all P < 0.001). In women, both WC and WHtR significantly predicted all cardiometabolic risk factors after 5 years. In men, even after adjusting WC threshold based on ROC analysis, WHtR better predicted overall 5-year risk. Neither measure predicted hypertension in men.

CONCLUSIONS:

The WHtR threshold of >0.5 appears to be more consistently supported and may provide a better predictor of future cardiometabolic risk in sub-Saharan Africa.

Copyright © 2014 Elsevier B.V. All rights reserved.

KEYWORDS:

Cardiovascular disease; Diabetes; Dyslipidaemia; Hypertension; Risk factors; Sub-Saharan Africa; Waist circumference; Waist-to-height ratio

PMID:
24675009
[PubMed - in process]
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