CLINICAL PREDICTABILITY OF THE WAIST-TO-HIP RATIO IN ASSESSMENT OF CARDIOVASCULAR-DISEASE RISK-FACTORS IN OVERWEIGHT, PREMENOPAUSAL WOMEN

The waist-to-hip ratio (WHR) is one of the most commonly used anthropo metric measures to indicate a central obesity pattern and an increased risk of cardiovascular disease in normal-weight women. Although the A merican Heart Association has reported that a WHR >0.80 be used to ind icate increased risk of cardiovascular disease in women, the present s tudy assessed the WHR above which is seen elevations in cardiovascular disease risk factors in a sample of overweight women, Using data from 240 women aged 27.5-47.5 y enrolled in a university weight-loss progr am, we determined WHR guar tiles: <0.80, 0.80 to <0.84, 0.84 to <0.90, and greater than or equal to 0.90. Subjects were placed into high-ris k categories for cardiovascular disease on the basis of age- and popul ation-defined norms, Women had an increased likelihood of elevated VLD L cholesterol, triacylglycerol, diastolic blood pressure, and composit e risk tie, having greater than or equal to 4 cardiovascular disease r isk factors) and an increased risk of having low concentrations of HDL at a WHR greater than or equal to 0.90. All aforementioned variables had a significant odds ratio at a WHR greater than or equal to 0.90 af ter adjustment for smoking, whereas elevated VLDL, triacylglycerol, an d diastolic blood pressure were observed at this WHR after adjustment for a body mass index tin kg/m(2)) < or greater than or equal to 35. O nly 2 variables, VLDL and triacylglycerol, had a significant odds rati o at a WHR <0.90 before and after adjustment for BMI and smoking. Thes e data suggest an upward shift in the critical threshold for WHR to gr eater than or equal to 0.90, at which point there was an elevation in cardiovascular disease risk factors in already overweight women. This trend persisted regardless of whether the women smoked or whether thei r body mass index was < or greater than or equal to 35.