Waist circumference and waist-to-hip ratio in Turkish adults: interrelation with other risk factors and association with cardiovascular disease

Objective: To investigate the distribution of waist circumference (WC) and waist-to-hip ratio (WHR), their relationships with a number of established risk factors and their relevance to cardiovascular morbidity in a random sa mple of Turkish general adult population. Design: Cross-sectional populatio n-based study. Subjects: The subjects comprised 958 men and 1014 women, age d 25-74 years. Measurement: Waist circumference was measured midway between the lower rib and iliac crest while that of the hip at the level of trocha nters. Mean of two blood pressure measurements was used for analysis. Plasm a total cholesterol (Cho) and triglyceride (Trg) concentrations were measur ed by the enzymatic dry method with a Reflotron apparatus. Results: Overall mean WC measured 93+/-12 cm in men, and 88.6+/-13 cm in women. Mean WHR wa s 0.919+/-0.077 and 0.823+/-0.074, respectively, and a rise by about 0.001 was associated with each year of age. In multiple regression analysis a mod el was utilized that included age, body mass index (BMI), systolic and dias tolic blood pressure (BP), plasma total Cho and Trg and category of smoking . This revealed age, BMI, and Trg as independent determinants of WHR in bot h genders, and diastolic BP in women alone. Age, BMI, and diastolic BP prov ed to be independently associated with WC in both genders, while Cho did so in men alone, Trg and systolic BP in women alone. Partial correlation coef ficients on univariate analysis between all four variables of blood pressur e and plasma lipids and either WC or WHR, controlled for age, were highly s ignificant though moderately weak in both genders. These were stronger in m en than in women, and stronger with respect to WC than to WHR. Cigarette sm oking men and women had significantly lower WC or WHR than nonsmokers and e x-smokers, though these associations did not prove to be independent. When the relevance of WC and WHR to CHD risk was tested in this cohort (for the age bracket 45-74 years) comprising 138 cases with a clinical diagnosis of CHD, only WHR in women proved to be significantly associated. Odds ratio fo r a value of >0.845 was 1.6. Conclusion: WC and WHR are strongly associated with BMI and age as well as with parameters reflecting insulin resistance such as diastolic blood pressure and plasma triglycerides. WHR was signific antly associated with coronary heart disease in Turkish women. (C) 1999 Els evier Science Ireland Ltd. All rights reserved.