1 / 17

J Am Coll Cardiol 2007;50:752-9

Waist-to-Hip Ratio is a Superior Predictor of Atherosclerosis Compared with Body Mass Index in a Population-Based Sample: Observations from the Dallas Heart Study. J Am Coll Cardiol 2007;50:752-9.

marek
Download Presentation

J Am Coll Cardiol 2007;50:752-9

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Waist-to-Hip Ratio is a Superior Predictor of Atherosclerosis Compared with Body Mass Index in a Population-Based Sample: Observations from the Dallas Heart Study J Am Coll Cardiol 2007;50:752-9 Raphael See, Shuaib Abdullah, Darren K. McGuire, Amit Khera, Mahesh J. Patel, Jason B. Lindsey, Scott M. Grundy, James A. de Lemos

  2. Background • Obesity is associated with an increased risk of CV mortality • Most prior studies examining CV risk have used BMI as the measure of obesity • BMI poorly characterizes central obesity • Waist circumference (WC) and waist-to-hip ratio (WHR) more strongly correlate with CV event rates Rimm EB, et al., Am J Epidemiol 1995;141:1117-27; Dagenais GR, et al., Am Heart J 2005;149:54-60.; Yusuf S, et al., Lancet 2005;366:1640-9.

  3. Obesity & CV Events Yusuf S, et al. Lancet 2005;366:1640-9

  4. Obesity & Coronary Artery Calcification • Cassidy et al: 443 non-diabetic, aSx white men • BMI, WC, & WHR independently associated with CAC in low risk men • Snell-Bergeon et al: 762 aSx subjects • BMI & WC independently associated with CAC in men & women • WHR associated with CAC only in men • Study populations were small, homogeneous, and selected Cassidy AE, et al., Circulation 2005;111:1877-82; Snell-Bergeon JK, et al. Int J Obes Relat Metab Disord 2004;28:1594-9.

  5. Objective • Determine the association between differing measures of obesity and atherosclerosis

  6. Dallas Heart Study: Population-based probability sample of 6,101 subjects Measures of body composition: Body mass index Waist circumference Waist-to-hip ratio Hip circumference Visit 1 Detailed health survey n=6,101 Visit 2 Blood / urine collection n=3,398 Visit 3 Anthropometrics EBCT/MRI n=2,971 2,744 subjects ages 30-65 with interpretable scan data Methods

  7. Measures of Atherosclerosis Coronary Artery Calcification by CT Abdominal Aortic Plaque by MRI

  8. Statistical Analysis • Sex-specific quintiles for each obesity measurement • BMI, WC, and WHR • Logistic regression analyses • Univariable models • Dependent variable: CAC or aortic plaque • Independent variables: obesity measures in quintiles • Multivariable models • Dependent variable: CAC or aortic plaque • Independent variables: obesity measures in quintiles + traditional CV risk factors • C-statistic comparisons for above models

  9. Quintile Cut-points

  10. Association Between Obesity & CAC

  11. Association Between Obesity & Aortic Plaque

  12. Association Between Obesity & CAC after MV adjustment Adjusted for: age, smoking, DM, dyslipidemia, low HDL, high TG

  13. Association Between Obesity & Aortic Plaque after MV Adjustment Adjusted for: age, smoking, DM, dyslipidemia, low HDL, high TG

  14. C-statistics from Univariable Models * P < 0.01 vs BMI ± p < 0.01 vs WC

  15. C-statistics from MV Models

  16. Waist & Hip Circumference Analyses Women “large” waist “normal” waist Men p-values for WCxHC interaction: Women < 0.01 Men = 0.07

  17. Conclusions • WHR is more closely associated with atherosclerosis than other measures of obesity • Independent of traditional risk factors • Did not increment the c-statistic over CV risk factor model • Superiority of WHR may be due to an interaction between WC & HC • Associations between differing measures of obesity and atherosclerosis resemble those with CV events • Suggest atherosclerosis may be a link between obesity and events

More Related