Abstract
To examine whether the association between waist circumference (WC) and clustering of cardiovascular risk factors varies with obesity (BMI) status. Using the 2008 health examination data of a Japanese health service association, eligible 57,141 adults aged 20-65 years without coronary heart disease or stroke, whose blood sample had been taken in the fasting state, were enrolled in the study. The participants were classified as being underweight (BMI <18.5), normal weight (BMI 18.5-24.9), and overweight (BMI ≥25.0). Multiple logistic regression analysis was performed to calculate adjusted odds ratios (OR) for clustering of cardiovascular risk factors. Receiver operating characteristic analysis was performed to assess the ability of WC to discriminate subjects with and without a clustering of cardiovascular risk factors. Clustering of cardiovascular risk factors was found in 16.0% of men and 3.4% of women. The adjusted OR [95% confidence intervals (CI)] per 5-cm increase in WC of the underweight, normal weight, and overweight groups was 1.57 (1.12-2.20), 1.55 (1.49-1.62), and 1.34 (1.30-1.38), respectively, for men and 1.50 (0.84-2.69), 1.53 (1.40-1.68), and 1.32 (1.23-1.41), respectively, for women. The area under curve (95% CI) of the underweight, normal weight, and overweight groups was 0.68 (0.59-0.77), 0.70 (0.69-0.71), and 0.62 (0.61-0.63), respectively, for men and 0.70 (0.53-0.86), 0.75 (0.73-0.78), and 0.64 (0.61-0.68), respectively, for women. High WC was associated with increased risk of clustering of cardiovascular risk factors independent of BMI. As well as the magnitude of the association, the ability of WC to discriminate subjects with and without a clustering of cardiovascular risk factors varied with obesity (BMI) status.
Highlights
The metabolic syndrome is characterized by a clustering of cardiovascular risk factors in one person, and those individuals with the metabolic syndrome are at increased risk of developing coronary heart disease and other arteriosclerotic diseases
High waist circumference (WC) was associated with increased risk of clustering of cardiovascular risk factors independent of Body mass index (BMI)
As well as the magnitude of the association, the ability of WC to discriminate subjects with and without a clustering of cardiovascular risk factors varied with obesity (BMI) status
Summary
The metabolic syndrome is characterized by a clustering of cardiovascular risk factors in one person, and those individuals with the metabolic syndrome are at increased risk of developing coronary heart disease and other arteriosclerotic diseases. Many investigators have reported an association between WC and clustering of cardiovascular risk factors and the Environ Health Prev Med (2011) 16:90–96 optimal WC cutoff for the detection of clustering of cardiovascular risk factors in Japanese adults [4,5,6,7,8,9,10,11,12,13]. There have been few studies that have assessed the association between WC and clustering of cardiovascular risk factors in terms of potential BMI dependence. It remains uncertain whether WC has an adequate ability to discriminate subjects with and without a clustering of cardiovascular risk factors within all BMI categories
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