Conicity Index and Waist-to-Hip Ratio Are Superior Obesity Indices in Predicting 10-Year Cardiovascular Risk Among Men and Women

Clin Cardiol. 2015 Sep;38(9):527-34. doi: 10.1002/clc.22437. Epub 2015 Sep 7.

Abstract

Background: Central obesity has been recognized as a main risk factor for cardiovascular (CV) events. Three popular central obesity indices are waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio; abdominal volume index and conicity index are 2 recent novel obesity indices. The main aim of this study is to determine the performance of these indices to best predict 10-year CV events.

Hypothesis: Some obesity indices can be used to predict cardiovascular risk.

Methods: In total, 3199 subjects (age range, 40-79 years) were enrolled in this cross-sectional study. The American College of Cardiology/American Heart Association and Framingham risk score tools were used to estimate the 10-year CV events. Receiver operating characteristic curve analysis was used to determine the optimal discriminator(s) among the central obesity measures in the estimation of a 10-year risk of CV events ≥7.5%, ≥10%, and ≥20% separately.

Results: Among the 5 central obesity indices, conicity index showed the most discriminatory power in estimation of a 10-year CV risk. In men, based on the American College of Cardiology/American Heart Association tool, the areas under the curve (AUCs) were from 0.671 to 0.682 based on the 3 above thresholds, whereas with the Framingham tool, AUCs were from 0.651 to 0.659. In women, all AUCs were >0.7. Our results also showed WHR to be an almost comparable discriminator of CV disease risk in the Iranian study population.

Conclusion: Conicity index and WHR had a more discriminatory accuracy for 10-year CV events compared with the other obesity indices.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Fat / physiopathology*
  • Adiposity*
  • Adult
  • Aged
  • Area Under Curve
  • Cardiovascular Diseases / etiology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Iran
  • Male
  • Middle Aged
  • Obesity, Abdominal / complications
  • Obesity, Abdominal / diagnosis*
  • Obesity, Abdominal / physiopathology
  • Predictive Value of Tests
  • ROC Curve
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Waist Circumference
  • Waist-Hip Ratio*