A COMPARATIVE-ANALYSIS OF WEIGHT TO HEIGHT AND WAIST-TO-HIP CIRCUMFERENCE INDEXES AS INDICATORS OF THE PRESENCE OF CARDIOVASCULAR-DISEASE RISK-FACTORS

Objective: To determine the mathematic formula for weight, height and waist and hip circumference that is most closely correlated to cardiov ascular disease risk factors. Design: Population-based, cross-sectiona l surveys. Setting: Five Canadian provinces, between 1990 and 1992. Pa rticipants: A probability sample of 16 007 men and women aged 18 to 74 years was selected using health insurance registration files in each province. Anthropometry was performed on 10 054 (63%) of these adults. Outcome measures: The power of height in the body mass index (BMI, kg /m(2)) and of hip circumference in the ratio of waist to hip circumfer ence (WC/HC) was varied from 0 to 3. Simple linear regression analysis for each age-sex group was used to examine the relation of each index to systolic and diastolic blood pressure (SBP and DBP), levels of tot al cholesterol (TC), low-density lipoprotein cholesterol (LDL) and hig h-density lipoprotein cholesterol (HDL), triglycerides (TRIG) and the ratio of TC to HDL. Values for the coefficient of determination (r(2)) were used to compare the fits of the models. Results: The r(2) values were generally low (< 0.27), but were greatest in the younger age gro ups (18-24 and 35-54 years) and in women. Waist circumference alone (W C/HC0) showed the best fit with SBP and DBP, whereas WC/HC0.5 was most closely related to HDL, TC/HDL and TRIG. None of the indices was clos ely associated with TC or LDL. Whatever the power of height used, the weight-height ratios showed weaker associations with the risk factors than the waist-hip ratios. Conclusions: WC and BMI correlate most clos ely with blood pressure and plasma lipid and may be the best simple an thropometric indices to include in the routine clinical examination of adults.