Tehran University Medical Journal

Background: Stenotic coronary arteryIt is essential to identify the best simple anthropometric index in any population to predict chronic disease risk. This study was designed to compare the ability of waist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) to predict cardiovascular risk factors in an urban adult population of Tehranian men.

Materials and Methods: This population-based cross-sectional study was conducted on 4449 men aged 18-74 years, participants of Tehran Lipid and Glucose Study (TLGS). Demographic data was collected. Anthropometric indices were measured according to standard protocol. Blood pressure was measured and hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as FBS≥126 mg/dl and dyslipidemia based on ATP II. The presence of “at least one” and “at least two” risk factors from the four major cardiovascular risk factors (hypertension, dyslipidemia, diabetes and smoking) was also evaluated.

Results: Mean age of men was 41.8±15.4. Mean BMI, WHR and waist circumference was 25.6±4.2 kg/m2, 0.91±0.07 and 87.7±11.7 cm, respectively. Of the three individual indicators, WHR had the highest sensitivity for all risk factors. No combination of indicators had higher average sensitivity + specificity than WHR alone. WHR had a higher percentage of correct prediction than BMI and waist circumference for all risk factors. No combination of measures was significantly more accurate than WHR alone, except for combinations where another indicator has been combined with WHR by “or”.

Conclusion: It is concluded that WHR is the best predictor of cardiovascular risk factors compared to BMI and WC in Tehranian adult men residing in district-13.

Background: Identification of the best screening measure for the risk of chronic disease is essential. This study aims to comparatively assess the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) to predict hypertension among women in Tehran.

Methods: In this population-based cross-sectional study, a representative sample of 926 adult women aged 40-60 years were selected using a multi-stage cluster random sampling method. Demographic data were collected and anthropometric measures including weight, height, WC and hip circumference were assessed according to a standard protocol. BMI was calculated as weight in kilograms divided by the square of the height in meters. Cut-off points of 80 cm for waist circumference, 25kg/m² for BMI, 0.87 for WHpR and 0.5 for WHtR were used. Blood pressure was measured and hypertension defined according to the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 6).

Results: In this study, the mean age of women is 48.7±5.6 years. Mean WC, BMI, WHpR and WHtR are 85.1±9.9cm, 29.4±4.6kg/m², 0.82±0.06 and 0.55±0.06, respectively. Although all anthropometric indicators have a significant association to hypertension, WC has the highest sensitivity, specificity and accuracy in predicting hypertension in both age groups of 40-50 and 50-60 years. This measure also has the greatest area under the ROC curve compared to other anthropometric measures: 0.70(0.69-0.71) for WC, 0.65(0.62-0.67) for BMI, 0.62(0.60-0.64) for WHpR and 0.65(0.63-0.67) for WHtR.

Conclusions: Among this group of women in Tehran, waist circumference is the best screening measure for hypertension. However, no data are available regarding similar patients who have emigrated thus similar studies on Iranian women who have emigrated are recommended.