Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Gao, Feng; Wan, Jindong; Xu, Bo; Wang, Xiaochen; Lin, Xianhe

doi:10.1159/000507708

Cited by 4 publications

(3 citation statements)

References 43 publications

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“…Although WHR was originally regarded as an indicator for abdominal obesity, its significance in predicting cardiovascular disease and other chronic complications is receiving increasing attention. An increasing WHR has been found to be associated with an increasing risk of myocardial infarction [ 28 ] and heart failure [ 29 ] after adjusting for BMI and other risk factors among those regarded as being very-below-normal weight or of normal weight. Men with the highest-quartile of WHR had multivariate-adjusted hazard ratios of 1.81 for total stroke and 2.26 for ischemic stroke compared with men with the lowest quartile of WHR [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Waist-hip ratio is an independent predictor of moderate-to-severe OSA in nonobese males: a cross-sectional study

2022

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Background Adiposity is a well-established risk factor for obstructive sleep apnea (OSA), but whether a combination of preferable anthropometric measurements may improve the accuracy of detecting OSA is unknown. This study aimed to explore the accuracies of the waist-hip ratio (WHR) in conjunction with the body mass index (BMI) when identifying the severity of OSA. Design A total of 2012 participants in the China-Japan Friendship Hospital from January 2018 to December 2019 underwent anthropometric measurements and an overnight home sleep test (HST). The 244 subjects who met the criteria for obstructive sleep apnea (apnea–hypopnea index (AHI) ≥ 5 events/hour) were divided into four groups: Group A (55 patients with WHR ≥ 0.9 and BMI ≥ 28 kg/m2); Group B (12 patients with WHR < 0.9 and BMI ≥ 28 kg/m2); Group C (69 patients with WHR ≥ 0.9 and BMI < 28 kg/m2); and group D (108 patients with WHR < 0.9 and BMI < 28 kg/m2). Results The AHI, apnea index (AI), hypopnea index (HI), and oxygen desaturation index (ODI) were significantly different among the 4 groups (p < 0.05). The WHR was positively correlated with AHI (r = 0.22, p < 0.001), AI (r = 0.270, p = 0.004), and ODI (r = 0.286, p = 0.0022) and negatively correlated with lowest oxygen pulse saturation (LSpO2) (r = 0.246, p = 0.008) only in nonobese patients. Moreover, the WHR was found to be a screening marker for moderate-to-severe OSA in Group D (p < 0.05). When used to identify severe OSA in Group D, the WHR cut-off point of 0.873 yielded a sensitivity of 65% and specificity of 56% (p < 0.05). Conclusion In nonobese male OSA patients, WHR is a moderate screening marker for moderate-to-severe OSA and an independent risk factor for OSA severity.

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Section: Discussionmentioning

confidence: 99%

Waist-hip ratio is an independent predictor of moderate-to-severe OSA in nonobese males: a cross-sectional study

2022

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“…Several previous studies have shown that WHR was strongly associated with cardiovascular metabolic characteristics, diabetes, coronary prospective cohort study of 1479 participants that higher WHR was independently associated not only with the prevalence of diabetes and the severity of heart failure, but also with higher mortality risk in women (hazard ratio: 2.23, 95% CI: 1.37-3.63, P < 0.05), but not in male participants, and they also found that WHR was positively correlated with inflammatory markers and mitogen-activated protein kinase cascade in female participants, whereas only positively correlated with platelet activity in men (19). Likewise, in a cohort study of 1396 heart failure participants with left ventricular ejection fraction of 40-49%, Gao et al showed that no matter how WHR changed over time, it was still significantly positively correlated with the risk of incident CVD, heart failure and all-cause death (hazard ratio: 2.32-4.03), which also highlighted the importance of long-term management of abdominal fat (33). Although the above studies confirmed the correlation between WHR and CVD and the risk of death, it failed to prove the causal relationship.…”

Section: Discussionmentioning

confidence: 97%

Association between waist-hip ratio and subclinical myocardial injury in the general population: Insights from the NHANES

Wang

Huang

Li³

et al. 2022

Front. Endocrinol.

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BackgroundAlthough studies have shown that higher waist-hip ratio (WHR) is closely related to higher risk of metabolism-related diseases, the relationship between WHR and subclinical myocardial injury (SC-MI) is unknown. This study was to evaluate the effect of WHR on SC-MI in the general population free from cardiovascular disease.MethodsThe cross-sectional study included 6253 participants without cardiovascular disease (CVD) from the third National Health and Nutrition Examination Survey (NHANES III) for further analysis. Restricted cubic spline, multivariable logistic regression models and subgroup analyses were performed to assess the association between WHR and SC-MI.ResultsThe multivariate logistic regression showed that after adjusting for potential confounding factors, participants in the higher quartiles had higher risk of developing SC-MI than those in the first quartile of WHR [Q3, OR (95% CI): 1.523 (1.159, 2.000), P = 0.002; Q4, OR (95% CI): 1.719 (1.279, 2.311), P < 0.001], and this relationship was robust among the participants aged ≥ 50 years, with hypertension and without diabetes. Every 0.1 unit increase in WHR, as a continuous variable, increased the risk of SC-MI by more than 20% [OR (95% CI): 1.233 (1.092, 1.392), P = 0.001]. And restricted cubic spline analysis showed that there was a linear positive correlation between WHR and the risk of SC-MI.ConclusionsWHR may be an independent risk factor for SC-MI in the general population free from CVD.

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“…These risks were shown later in the context of a wide range of comorbidities. Paradigmatic examples are the associations with type 2 diabetes [29,30], hyperuricemia [31], elevation of free T 3 and MRI-assessed abdominal fat distribution [32], heart failure mid-range ejection fraction [33], and even prevalent or previous metabolic syndrome. These relationships were established by means of different waist circumference-derived indices [34].…”

Section: Discussionmentioning

confidence: 99%

Estimating trunk fat in children according to sex using basic somatic readings: an opportunity for improving evaluation among girls

Benavent

Pérez‐Fernández

2021

BMC Pediatr

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Background The fat mass estimators waist-to-height ratio (WHtR) and relative fat mass—pediatric (RFMp) complement the widely accepted body mass index (BMI) in obesity evaluation. Aims of the Study: Conduct an easy appraisal of trunk fat and the cardiometabolic risk associated with pediatric obesity. Methods A total of 472 children (39% boys in the total sample) were classified as underweight, normal weight, overweight or obese (nutritional groups, NGs) according to BMI Z-score after initial anthropometric data were obtained and ad hoc exclusion criteria were applied. WHtR and RFMp (% of total fat) were calculated for each group, associations were assessed through multiple linear regression (MLR), and differences between sexes were evaluated (medians, IQR). Results The mean age (mean (95% CI)) was 10.8 y (10.1–11.1). The values in the total sample were as follows: WHtR, 0.5 (0.49–0.51) and RFMp%, 32.3 (31.7–33.0). In the overweight group, the values were as follows: WHtR, 0.51 (0.50–0.52) and RFMp(%), 34.2 (33.3–35.1). In the obese group, the values were as follows: WHtR, 0.56 (0.55–0.57) and RFMp(%), 37.8 (36.9–38.6). The associations were as follows (NG; independent variables): In the NG, adjusted R2 values were between 0.74 and 0.78. In the total sample, the beta coefficient was 3.36 (P < 0.001) for RFMp for girls; for waist circumference (WC), the beta coefficient was 2.97 (P < 0.001), and for WHtR the beta coefficients were − 0.01 (p < 0.001) and 0.03 (p < 0.001),for girls and for WC respectively. The sex differences were as follows: BMI exhibited no differences in the NG (Mann-Whitney U). WHtR (median (IQR)) differed (M vs. F) in the total sample (0.49 (0.45–0.54) vs. 0.52 (0.45–0.56), p < 0.004); in the overweight group (0.51 (0.48–0.53) vs. 0.54 (0.51–0.55), p < 0.001); and in the obese group (0.55 (0.52–0.57) vs. 0.57 (0.54–0.60), p < 0.004). RFMp (%) differed in the total group (29.21 (24.27–32.92) vs. 36.63 (30.2–39.51), p < 0.001); in the overweight group (31.24 (28.35–32.35) vs. 37.95 (35.75–38.82), p < 0.001) and in the obese group (35.89 (32.05–36.15) vs. 40.63 (38.27–42.42), p < 0.001). Conclusions WHtR and RFMp are simple and reliable indices that do not require centile charts. Their values, including waist circumference, can be used to estimate the different trunk fat components in boys and girls better than BMI, especially if individuals are overweight or obese. RFMp proved to be more reliable as it considers sex. Both should be included in routine anthropometric readings.

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Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Cited by 4 publications

References 43 publications

Waist-hip ratio is an independent predictor of moderate-to-severe OSA in nonobese males: a cross-sectional study

Waist-hip ratio is an independent predictor of moderate-to-severe OSA in nonobese males: a cross-sectional study

Association between waist-hip ratio and subclinical myocardial injury in the general population: Insights from the NHANES

Estimating trunk fat in children according to sex using basic somatic readings: an opportunity for improving evaluation among girls

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