USE OF ANTHROPOMETRIC MEASUREMENTS IN ASSESSING RISK FOR CORONARY HEART-DISEASE - A USEFUL TOOL IN WORKSITE HEALTH SCREENING

The study examined the association between the anthropometric measurem ents body mass index (BMI), waist/hip ratio (WHR), and waist/thigh rat io (WTR) and cardiovascular risk factors, and assessed whether a combi nation of BMI and WHR could be used in routine screening of risk for c ardiovascular arteriosclerotic disease at worksites. The data were obt ained from a cross-sectional survey designed to assess the nutritional situation, with special reference to cardiovascular risk factors. The study population comprised 372 healthy men working on platforms in th e North Sea. Serum cholesterol, triglyceride, fibrinogen, and blood pr essure were positively related to the anthropometric variables, while high-density lipoprotein (HDL) was inversely related with them. The re lations remained after adjusting for possible confounders, such as age , smoking, physical activity, and an indicator of dietary fat intake. In stepwise multiple linear regression models, BMI, WHR, and WTR were positively related to serum cholesterol, triglycerides, fibrinogen, di astolic blood pressure, and systolic blood pressure, and inversely rel ated to HDL. When controlling for the anthropometric variables WHR and WTR, BMI was not independently related to fibrinogen and risk score. WHR and WTR were not independently related to systolic and diastolic b lood pressure, and WTR was in addition not related to triglycerides wh en controlling for BMI. Overall, the anthropometric variables BMI and WHR were considered the best predictors for CAD risk when taking sever al risk factors into consideration. A joint variable between BMI and W HR, called ''body score'', constituted the four categories lean, lean android, overweight gynoid, and overweight ovoid. This body score was positively associated with levels of serum lipids, fibrinogen, and blo od pressure, and inversely associated with HDL. In stepwise multiple l inear regression models, controlling far possible confounding variable s, body score was positively related to CAD risk. Dividing the risk sc ore into tertiles, about 51% of the lean were in the first, while 46% of the overweight ovoid were in the third tertile. Those classified as lean android or overweight gynoid had about the same distribution, na mely between 31% and 39% in each tertile if the two categories were co mbined. These data support the hypothesis that BMI, WHR, and WTR are i ndependent predictors for risk factors for CAD among oil workers, and that combinations of BMI and WHR are strong enough predictors to be us eful in routine screening for CAD risk at worksites. Based on these fi ndings, supported by data from the literature, a matrix aimed at scree ning for follow-up at worksites is proposed.