Abstract
ABSTRACTOBJECTIVE To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference.METHODS A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories.RESULTS The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16–1.63) and 1.35 (95%CI 1.12–1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference.CONCLUSIONS The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.
Highlights
Obesity and, more recently, overweight have been recognized as major public health problems in many countries[1], including Brazil[2], and several attempts have been made to identify the best anthropometric predictor[3] for several non-communicable diseases and complications in different populations and age groups
The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk
When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16–1.63) and 1.35 (95%CI 1.12–1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference
Summary
More recently, overweight have been recognized as major public health problems in many countries[1], including Brazil[2], and several attempts have been made to identify the best anthropometric predictor[3] for several non-communicable diseases and complications in different populations and age groups. As the relationship between BMI and the risk of morbidities can be affected by the body fat distribution, regardless of the body weight[5], studies have recommended the combination of this index with other measurements of abdominal adiposity, with emphasis on WC, for a better diagnosis of overweight as a health risk predictor[6,7,8]. Excess abdominal fat has been associated with disorders in glucose and lipid metabolism, which relate to cardiovascular diseases, insulin resistance, and systemic arterial hypertension (SAH)[9]. For these reasons, WC has been recommended as a cardiometabolic risk anthropometric marker6.10
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