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Waist-height ratio as a predictor of coronary heart disease among women.

Published on May 1, 2009in Epidemiology 4.72
· DOI :10.1097/EDE.0b013e31819f38f1
John H. Page17
Estimated H-index: 17
,
Kathryn M. Rexrode72
Estimated H-index: 72
+ 3 AuthorsJoAnn E. Manson231
Estimated H-index: 231
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Abstract
Background: It is not yet established what specific measures of obesity might be most strongly associated with risk of coronary artery disease. We compared the waist-height ratio to waist-hip ratio, waist circumference, and body mass index as predictors of subsequent coronary heart disease (CHD) in a group of predominantly postmenopausal women. Methods: The data come from the prospective Nurses' Health Study cohort. We included 45,563 women in 1986 who were aged 40-65 years and were free of heart disease, stroke, and cancer. Waist circumference, hip circumference, height, weight, age, and other covariates were collected by questionnaire. Our primary end point was incident coronary heart disease reported up to June 2002. Areas under the receiver operating characteristic curves (AUCs) were estimated nonparametrically for each of the anthropometric measures. We estimated differences between the AUCs for weight-height ratio and the other measures, with corresponding 95% confidence intervals. We used Cox proportional hazard models to estimate the relationships with risk of CHD. Results: Waist-height ratio, waist-hip ratio, and waist circumference were similar in predicting subsequent risk of CHD. All 3 waist-derived measures were superior to body-mass index (BMI) in predicting CHD. The unadjusted AUCs were 0.62 (95% confidence interval = 0.60-0.64) for waist-height ratio, 0.63 (0.61-0.65) for waist-hip ratio, 0.62 (0.60-0.64) for waist-circumference, and 0.57 (0.55-0.59) for BMI. Conclusion: Waist-height ratio is comparable with waist circumference and waist-hip ratio for prediction of coronary heart disease incidence among middle-aged and older women, but superior to BMI.
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  • Citations (41)
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References21
Newest
Published on Mar 24, 2008in Circulation 23.05
Cuilin Zhang46
Estimated H-index: 46
,
Kathryn M. Rexrode72
Estimated H-index: 72
+ 2 AuthorsFrank B. Hu202
Estimated H-index: 202
Background— Accumulating evidence indicates that abdominal adiposity is positively related to cardiovascular disease (CVD) risk and some other diseases independently of overall adiposity. However, the association of premature death resulting from these diseases with abdominal adiposity has not been widely studied, and findings are inconsistent. Methods and Results— In a prospective cohort study of 44 636 women in the Nurses’ Health Study, associations of abdominal adiposity with all-cause and ca...
448 Citations Source Cite
Published on Aug 21, 2007in Osteoporosis International 3.82
Siri Forsmo21
Estimated H-index: 21
(NTNU: Norwegian University of Science and Technology),
H. M. Hvam1
Estimated H-index: 1
(NTNU: Norwegian University of Science and Technology)
+ 3 AuthorsArnulf Langhammer33
Estimated H-index: 33
(NTNU: Norwegian University of Science and Technology)
Summary In a population-based cohort of 1,421 women 45–60 years old followed for 15.5 years, 71% of the women had lost height. Height loss was associated with low forearm bone density and increased bone loss, but high body weight and oestrogen therapy were protective factors. Increased height loss indicates a generalized state of bone loss.
11 Citations Source Cite
Published on Sep 1, 2005in Diabetes Care 15.27
Chin-Hsiao Tseng39
Estimated H-index: 39
Extreme obesity has been shown to be associated with focal-segmental glomerulosclerosis and nephrotic syndrome in a report of four cases (1). However, this association has not gained much attention until recently when histologically proven glomerulopathy was demonstrated in animals (2) and humans (3). The study of renal biopsy taken from humans included mostly patients with clinical proteinuria or proteinuria with renal insufficiency (3). Therefore, whether obesity is associated with nephropathy...
28 Citations Source Cite
Published on Mar 1, 2005in Diabetes 7.20
Francine Einstein15
Estimated H-index: 15
,
Gil Atzmon44
Estimated H-index: 44
(Yeshiva University)
+ 5 AuthorsNir Barzilai69
Estimated H-index: 69
Increased visceral adiposity is a pivotal component of the metabolic syndrome. Differential gene expression patterns of fat-derived peptides (FDPs) in visceral fat and subcutaneous fat have been characterized in the fasting state. Here we examined whether delivery of nutrients differentially affects the expression of FDPs in visceral fat versus subcutaneous fat (in the fed state). We increased the rate of glucose flux into adipose tissue of normal rats ( n = 16) by hyperglycemia or hyperinsuline...
98 Citations Source Cite
Published on Feb 1, 2005in Preventive Medicine 3.45
Shiun Dong Hsieh7
Estimated H-index: 7
,
Takashi Muto24
Estimated H-index: 24
(Dokkyo University)
Abstract Backgrounds . Overtly obesity is relatively rare among the Japanese despite the high prevalence of metabolic disorders, which suggests the need to develop simple and effective methods for assessing metabolic risks among the non-obese individuals as part of public health education. Methods . We compared body mass index (BMI), waist circumference, and waist-to-height ratio (W/Ht) as indices for evaluation of clustering of coronary risk factors (hypertension, hyperglycemia, hypertriglyceri...
159 Citations Source Cite
Published on May 29, 2003
Margaret Sullivan Pepe1
Estimated H-index: 1
1. Introduction 2. Measures of Accuracy for Binary Tests 3. Comparing Binary Tests and Regression Analysis 4. The Receiver Operating Characteristic Curve 5. Estimating the ROC Curve 6. Covariate Effects on Continuous and Ordinal Tests 7. Incomplete Data and Imperfect Reference Tests 8. Study Design and Hypothesis Testing 9. More Topics and Conclusions References/Bibliography Index
1,653 Citations
Published on Oct 1, 2002in Diabetes 7.20
Ilan Gabriely22
Estimated H-index: 22
(Yeshiva University),
Xiao Hui Ma9
Estimated H-index: 9
(Yeshiva University)
+ 6 AuthorsNir Barzilai69
Estimated H-index: 69
(Yeshiva University)
Age-dependent changes in insulin action and body fat distribution are risk factors for the development of type 2 diabetes. To examine whether the accumulation of visceral fat (VF) could play a direct role in the pathophysiology of insulin resistance and type 2 diabetes, we monitored insulin action, glucose tolerance, and the expression of adipo-derived peptides after surgical removal of VF in aging (20-month-old) F344/Brown Norway (FBN) and in Zucker Diabetic Fatty (ZDF) rats. As expected, perip...
429 Citations Source Cite
Published on Jan 1, 1999in Diabetes 7.20
Nir Barzilai69
Estimated H-index: 69
,
Li She1
Estimated H-index: 1
(Yeshiva University)
+ 4 AuthorsLuciano Rossetti75
Estimated H-index: 75
(Yeshiva University)
We directly examined whether visceral fat (VF) modulates hepatic insulin action by randomizing moderately obese (body wt approximately 400 g) Sprague-Dawley rats to either surgical removal of epididymal and perinephric fat pads (VF-; n = 9) or a sham operation (VF+; n = 11). Three weeks later, total VF was fourfold increased (8.5 +/- 1.2 vs. 2.1 +/- 0.3 g, P
326 Citations Source Cite
Published on Dec 2, 1998in JAMA 51.27
Kathryn M. Rexrode72
Estimated H-index: 72
,
Vincent J. Carey60
Estimated H-index: 60
+ 5 AuthorsJoAnn E. Manson231
Estimated H-index: 231
Context.—Obesity is a well-established risk factor for coronary heart disease (CHD), but whether regional fat distribution contributes independently to risk remains unclear.Objective.—To compare waist-hip ratio (WHR) and waist circumference in determining risk of CHD in women.Design and Setting.—Prospective cohort study among US female registered nurses participating in the Nurses' Health Study conducted between 1986, when the nurses completed a questionnaire, and follow-up in June 1994.Particip...
1,037 Citations Source Cite
Cited By41
Newest
Published on Mar 4, 2019in Journal of The Air & Waste Management Association 1.86
Hoang Anh Le (VNUHCM: Vietnam National University, Ho Chi Minh City)
ABSTRACTLittle is known about personal exposure levels of black carbon (BC), a fraction of PM2.5, specifically in the transport microenvironments. In this study, real-time personal exposure to BC recorded by a portable microAeth AE51 was investigated in microenvironments in a round-trip from Hanoi (Vietnam) directly to Singapore. Personal exposure to BC was monitored in microenvironments at residential flat, in various surface modes of transport (taxi, bus, train), at the airports, and on the ai...
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Published on Feb 18, 2019in Public Health Nutrition 2.53
Jaeeun Myung (Yonsei University), Kyung Yoon Jung (Yonsei University)+ 1 AuthorsEuna Han
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Published on Jun 1, 2018in American Journal of Epidemiology 4.47
Maryam Shakiba7
Estimated H-index: 7
(University of Gilan),
Mohammad Ali Mansournia18
Estimated H-index: 18
(Tehran University of Medical Sciences)
+ 3 AuthorsJay S. Kaufman57
Estimated H-index: 57
(McGill University)
4 Citations Source Cite
Published on Aug 1, 2017in Journal of Thrombosis and Thrombolysis 2.94
Kyusik Kang12
Estimated H-index: 12
(Eulji University),
Wong-Woo Lee1
Estimated H-index: 1
(Eulji University)
+ 3 AuthorsByung Kun Kim7
Estimated H-index: 7
(Eulji University)
Although a positive association between body mass index (BMI) and stroke incidence has been reported, having a higher BMI is known to be advantageous in surviving and recovering from stroke. The association between adiposity and stroke incidence is more evident for measures of abdominal obesity than for general obesity. The aim of our study was to compare BMI, waist circumference, and waist-height ratio (WHR) as predictors of 3-month functional outcome in stroke patients. The BMI, waist circumfe...
1 Citations Source Cite
Published on May 1, 2017in Revista Portuguesa De Pneumologia 2.10
Paula Caitano Fontela3
Estimated H-index: 3
(UFRGS: Universidade Federal do Rio Grande do Sul),
Eliane Roseli Winkelmann2
Estimated H-index: 2
(Universidade de Cruz Alta),
Paulo Ricardo Nazário Viecili8
Estimated H-index: 8
Resumo Introducao e objetivo A obesidade e um importante fator de risco para doencas cardiovasculares. O objetivo deste estudo foi avaliar se o indice de conicidade (IC), indice de massa corporal (IMC) e circunferencia abdominal (CA) podem ser usados como preditores de doenca arterial coronariana (DAC) e mortalidade em uma populacao de meia‐idade da regiao noroeste do Rio Grande do Sul, Brasil. Metodos Estudo de coorte retrospectiva, longitudinal, realizado com o registro dos prontuarios de indi...
2 Citations Source Cite
Published on May 1, 2017
Paula Caitano Fontela3
Estimated H-index: 3
(UFRGS: Universidade Federal do Rio Grande do Sul),
Eliane Roseli Winkelmann2
Estimated H-index: 2
(Universidade de Cruz Alta),
Paulo Ricardo Nazário Viecili8
Estimated H-index: 8
Abstract Introduction and Objective Obesity is a major risk factor for cardiovascular disease. This study was designed to assess whether the conicity index (CI), body mass index (BMI) and waist circumference (WC) can be used as predictors of coronary artery disease (CAD) and mortality in a middle-aged population of the north-western region of Rio Grande do Sul, Brazil. Methods This was a retrospective, longitudinal cohort study, based on the medical records of patients seen in a cardiology insti...
1 Citations Source Cite
Published on Nov 1, 2016in Journal of Obstetrics and Gynaecology Research 1.12
Xia Cao7
Estimated H-index: 7
(CSU: Central South University),
Jiansong Zhou12
Estimated H-index: 12
(CSU: Central South University)
+ 1 AuthorsZhiheng Chen5
Estimated H-index: 5
(CSU: Central South University)
Aim This study aimed to assess the associations between menstrual characteristics and the prevalence of metabolic syndrome (MetS) and non-alcoholic fatty liver disease. Methods A cross-sectional study was conducted with a sample of 1625 postmenopausal women in China. Subjects were classified into three groups according to the tertiles of some variables related to the reproductive life. We assessed associations in multivariable-adjusted analyses, using logistic regressions. Results After adjustme...
1 Citations Source Cite
Published on Oct 6, 2016in PeerJ 2.35
Nassib Bezerra Bueno4
Estimated H-index: 4
(UFAL: Federal University of Alagoas),
Telma Maria de Menezes Toledo Florêncio16
Estimated H-index: 16
(UFAL: Federal University of Alagoas)
+ 3 AuthorsAna Lydia Sawaya28
Estimated H-index: 28
(UNIFESP: Federal University of São Paulo)
1 Citations Source Cite
Published on Jul 1, 2016in Womens Health Issues 1.96
Jane A. McElroy15
Estimated H-index: 15
(MU: University of Missouri),
Suzanne G. Haynes6
Estimated H-index: 6
(HHS: United States Department of Health and Human Services)
+ 4 AuthorsAlexandra M. Minnis20
Estimated H-index: 20
(RTI International)
Abstract Background Lesbian and bisexual women are more likely to be overweight or obese than heterosexual women, leading to increased weight-related health risks. Methods Overweight women aged 40 or older who self-identified as lesbian, bisexual, or “something else” participated in five pilot interventions of 12 or 16 weeks' duration. These tailored interventions took place at lesbian and bisexual community partner locations and incorporated weekly group meetings, nutrition education, and physi...
6 Citations Source Cite
Published on Apr 2, 2016in British Journal of Cardiac Nursing
Wendan Shi1
Estimated H-index: 1
,
Lis Neubeck18
Estimated H-index: 18
,
Robyn Gallagher21
Estimated H-index: 21
Obesity-related chronic illness is an international health issue. Waist circumference can assess central adiposity, which is strongly associated with cardiovascular disease and type two diabetes mellitus. Aim: This study evaluates the effectiveness of waist circumference in comparison to body mass index as measured at different locations in adults with cardiovascular disease or type two diabetes mellitus, and responsiveness of these measures to weight change. Results: All measures were significa...
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