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Arch Gerontol Geriatr. 2016 Jul-Aug;65:174-82. doi: 10.1016/j.archger.2016.03.021. Epub 2016 Mar 31.

Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review.

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Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil. Electronic address:
Postgraduate Program of Nursing, Federal University of Pelotas, Brazil.
Postgraduate Program of Public Health, Federal University of Espírito Santo, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.


A systematic review was carried out aiming to collect evidence on the use of the waist-to-height ratio (WHtR) on the elderly population, focusing on validity measures to identify the best anthropometric indicator in assessing obesity associated with non-communicable diseases. The review consisted in a search of papers published on the databases Pubmed, Web of Science, and Lilacs, with no restriction regarding period of publication, using the following combinations: abdominal fat or overweight or obesity and waist-to-height ratio or waist height or waist ht or WHtR or waist to stature ratio or wst stature or WSR or stature and girth. Sixteen papers were selected, most of which with high methodological quality. The receiver-operating characteristic (ROC) curves was the validity measure explored in 13 papers, followed by sensitivity and specificity measures. In all studies, the body mass index (BMI) and waist circumference (WC) received special attention for analysis along with WHtR. Five manuscripts showed evidence of WHtR being the best anthropometric index when used alone, four showed that both WHtR and WC had the best discriminatory power in predicting cardiovascular risk factors compared to the other indices, and two ranked WHtR at the same performance level as waist-to-hip ratio (WHR) and BMI. An association was shown of the obesity assessed by WHtR in predicting risk factors for cardiovascular diseases, metabolic syndrome, and diabetes compared to other anthropometric parameters.


Anthropometric indices; Cardiovascular risk factors; Obesity; ROC curve; Waist-to-Height ratio (WHtR)

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