Abstract 3222: The Waist Index Is Better Associated with History of Myocardial Infarction than Body Mass Index, Waist Circumference and Waist-to-Hip Ratio
Central obesity measures appear to predict cardiovascular (CV) risk better than body mass index (BMI). However, it is still controversial which measure of central obesity is the best. In addition, different cut-off values of waist circumference (WC) have to be considered for different ethnicities. We hypothesized that the waist index (WI) calculated as WC, adjusted for height3 (~volume) could be a better measure of CV risk and could obviate the need for specific cut-offs for different ethnicities. A cross-sectional study of 16,778 subjects (≥20 yr, 53% women), who had full assessment of anthropometric variables and CV risk factors from NHANES III. We estimated the association between obesity measures (highest vs. lowest sex-specific quartile), such as BMI, WC, waist-to-hip ratio (WHR), and our proposed WI (cm/ht3), with self-reported history of myocardial infarction (MI). After adjustment for age, sex, race, dyslipidemia, hypertension, diabetes and smoking, subjects in the highest quartile of BMI and WC had a trend to be at higher risk for MI, while WHR and especially WI were significantly associated with MI (Figure⇓). Moreover, WI but not other obesity measures, discriminated between low, medium and high risk for MI, as noted by the strong association even at the intermediate quartiles. The WI is easily calculated and seems to be a better anthropometric measure to estimate the risk of MI than BMI, WC and WHR. Because this index accounts for subjects’ height, which is known to differ among ethnicities, it may obviate the need for different cut-offs of waist for each ethnicity to estimate CV risk.
This research has received full or partial funding support from the American Heart Association, AHA Midwest Affiliate (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota & Wisconsin).