The Predictive Value of Different Measures of Obesity for Incident Cardiovascular Events and Mortality

Schneider, Harald J.; Friedrich, Nele; Klotsche, Jens; Pieper, Lars; Nauck, Matthias; John, Ulrich; Dörr, Marcus; Felix, Stephan B.; Lehnert, Hendrik; Pittrow, David; Silber, Sigmund; Völzke, Henry; Stalla, Günter; Wallaschofski, Henri; Wittchen, Hans‐Ulrich

doi:10.1210/jc.2009-1584

Cited by 373 publications

(387 citation statements)

References 35 publications

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“…The association was stronger than BMI, waist‐to‐hip ratio and waist circumference 53. Similar results were found in a study of German patients 54. A meta‐analysis of studies that evaluated different measures of obesity as predictors of cardiovascular events also found that waist‐to‐height ratio was the best predictor of cardiovascular events 55.…”

Section: Alternative Indices Of Obesitysupporting

confidence: 78%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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Obesity and heart failure are two of the leading causes of morbidity and mortality in the world. The relationship between obesity and cardiovascular diseases is complex and not fully understood. While the risk of developing heart failure has been shown to be higher in patients who are obese, there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients. This phenomenon was first described by Horwich et al. and was subsequently confirmed in other large trials. The advantage exists irrespective of the type, aetiology, or stage of heart failure. Patients with morbid obesity (body mass index >40 kg/m2), however, do not have the same survival advantage of their obese counterparts. There are several alternative indices of obesity available that may be more accurate than body mass index. The role of weight loss in patients with heart failure is unclear; thus, providing sound clinical advice to patients remains difficult. Future prospective trials designed to evaluate the link between obesity and heart failure will help us understand more fully this complex relationship.

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Section: Alternative Indices Of Obesitysupporting

confidence: 78%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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“…For WHtR, the AUC was 66 % for men and 78 % for women. There are many studies evaluating the predictive power of anthropometric indices for cardiovascular deaths, CVD, hypertension, cardiometabolic risks, diabetes and dyslipidaemia (3,13,(31)(32)(33)(34)(35) . Systemic reviews and metaanalyses have shown that WHtR is superior in estimating cardiometabolic risks.…”

Section: Obesitymentioning

confidence: 99%

Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

Meseri

Uçku

Unal

2013

Public Health Nutr.

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Objective: To determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR. Design: Population-based cross-sectional study. Setting: Balcova, Izmir, Turkey. Subjects: Individuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as 'medium or high risk'. Results: Among the participants, 67?7 % were female, 38?2 % were obese, 24?5 % had high blood pressure, 9?2 % had diabetes, 1?5 % had undiagnosed diabetes ($126 mg/dl), 22?0 % had high total cholesterol and 45?9 % had low HDLcholesterol. According to Framingham risk score, 32?7 % of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0?55 was the optimal cut-off point for WHtR for CHD risk. Conclusions: BMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of '0?5' can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.

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“…Measures of abdominal obesity, principally waist circumference and WHR, are used as surrogates of body fat centralization and have been used to evaluate CVD risk (31,32) . Obesity was more strongly related to TAG than other variables in both sexes.…”

Section: Discussionmentioning

confidence: 99%

Vegetarian diet and cholesterol and TAG levels by gender

Jian

Chiang

Lung

et al. 2014

Public Health Nutr.

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Objective: The present study assessed the effects of vegetarian and omnivorous diets on HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), TAG and the ratio of HDL-C to total cholesterol (TC) by gender. Design: HDL-C, LDL-C, TAG and HDL-C:TC were compared among three diet groups (vegan, ovo-lacto vegetarian and omnivorous). Multivariate linear regression analysis was performed to examine factors significantly and independently associated with vegetarian status and to estimate the β value of lipid profiles for the diet groups. Settings: A cross-sectional study. Data were obtained from the Taiwanese Survey on the Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension (TwSHHH). Subjects: The study comprised included 3257 men and 3551 women. Results: After adjusting for confounders, vegan and ovo-lacto vegetarian diets lowered LDL-C levels (β = − 10·98, P = 0·005 and β = − 7·12, P = 0·025, respectively) in men compared with omnivorous diet. There was a significant association between HDL-C and vegan diet (β = − 6·53, P = 0·004). In females, the β values of HDL-C, TAG and HDL-C:TC were − 5·72 (P < 0·0001), 16·51 (P = 0·011) and − 0·02 (P = 0·012) for vegan diet, and − 4·86 (P = 0·002), 15·09 (P = 0·008) and − 0·01 (P = 0·026) for ovo-lacto vegetarian diet, when compared with omnivorous diet. Conclusions: Vegan diet was associated with lower HDL-C concentrations in both males and females. Because the ovo-lacto vegetarian diet was effective in lowering LDL-C, it may be more appropriate for males.

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The Predictive Value of Different Measures of Obesity for Incident Cardiovascular Events and Mortality

Abstract: WHtR represents the best predictor of cardiovascular risk and mortality, followed by WC and WHR. Our results discourage the use of the BMI.

Cited by 373 publications

References 35 publications

Obesity paradox in heart failure: a heavy matter

Obesity paradox in heart failure: a heavy matter

Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

Vegetarian diet and cholesterol and TAG levels by gender

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