Please use this identifier to cite or link to this item:
https://hdl.handle.net/20.500.14279/9865
Title: | Predicting cardiometabolic risk: Waist-to-height ratio or BMI. A meta-analysis | Authors: | Savva, Savvas C. Lamnisos, Demetris Kafatos, Anthony George |
Major Field of Science: | Medical and Health Sciences | Field Category: | Health Sciences | Keywords: | Body mass index;Cardiometabolic;Meta-analysis;Waist-to-height ratio | Issue Date: | 24-Oct-2013 | Source: | Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2013, vol. 6, pp. 403-419 | Volume: | 6 | Start page: | 403 | End page: | 419 | Journal: | Diabetes, Metabolic Syndrome and Obesity | Abstract: | Background and objectives: The identification of increased cardiometabolic risk among asymptomatic individuals remains a huge challenge. The aim of this meta-analysis was to compare the association of body mass index (BMI), which is an index of general obesity, and waist-to-height ratio (WHtR), an index of abdominal obesity, with cardiometabolic risk in cross-sectional and prospective studies. Methods: PubMed and Embase databases were searched for cross-sectional or prospective studies that evaluated the association of both BMI and WHtR with several cardiometabolic outcomes. The strength of relative risk (RR) with 95% confdence interval (CI) was calculated using the optimal cutoffs of BMI and WHtR in cross-sectional studies, while any available cutoff was used in prospective studies. The pooled estimate of the ratio of RRs (rRR [=RRBMI/ RRWHtR]) with 95% CIs was used to compare the association of WHtR and BMI with car-diometabolic risk. Meta-regression was used to identify possible sources of heterogeneity between the studies. Results: Twenty-four cross-sectional studies and ten prospective studies with a total number of 512,809 participants were identifed as suitable for the purpose of this meta-analysis. WHtR was found to have a stronger association than BMI with diabetes mellitus (rRR: 0.71, 95% CI: 0.59-0.84) and metabolic syndrome (rRR: 0.92, 95% CI: 0.89-0.96) in cross-sectional studies. Also in prospective studies, WHtR appears to be superior to BMI in detecting several outcomes, including incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality. The usefulness of WHtR appears to be better in Asian than in non-Asian populations. BMI was not superior to WHtR in any of the outcomes that were evaluated. However, the results of the utilized approach should be interpreted cautiously because of a substantial heterogeneity between the results of the studies. Meta-regression analysis was performed to explain this heterogeneity, but none of the evaluated factors, ie, sex, origin (Asians, non-Asians), and optimal BMI or WHtR cutoffs were signifcantly related with rRR. Conclusion: The results of this meta-analysis support the use of WHtR in identifying adults at increased cardiometabolic risk. However, further evidence is warranted because of a substantial heterogeneity between the studies. | URI: | https://hdl.handle.net/20.500.14279/9865 | ISSN: | 11787007 | DOI: | 10.2147/DMSO.S34220 | Rights: | © Savva et al. | Type: | Article | Affiliation : | Cyprus Dietetic and Nutrition Association European University Cyprus University of Crete School of Medicine |
Publication Type: | Peer Reviewed |
Appears in Collections: | Άρθρα/Articles |
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