Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults
Date
2014Author
Ware, L.J.
Kruger, H.S.
Kruger, I.M.
Greeff, M.
Fourie, C.M.T.
Huisman, H.W.
Scheepers, J.D.W.
Uys, A.S.
Kruger, R.
Van Rooyen, J.M.
Schutte, R.
Schutte, A.E.
Metadata
Show full item recordAbstract
Background and aims Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD risk.
Methods and results Black South Africans (577 men, 942 women, aged >30years) were recruited by random household selection from four North West Province communities. Demographic and anthropometric measures were taken. Recommended diagnostic thresholds (WC > 80 cm for women, >94 cm for men; WHtR > 0.5) were evaluated to predict blood pressure, fasting blood glucose, lipids, and glycated haemoglobin measured at baseline and 5 year follow up. Women were significantly more overweight than men at baseline (mean body mass index (BMI) women 27.3 ± 7.4 kg/m2, men 20.9 ± 4.3 kg/m2); median WC women 81.9 cm (interquartile range 61–103), men 74.7 cm (63–87 cm), all P < 0.001). In women, both WC and WHtR significantly predicted all cardiometabolic risk factors after 5 years. In men, even after adjusting WC threshold based on ROC analysis, WHtR better predicted overall 5-year risk. Neither measure predicted hypertension in men.
Conclusions The WHtR threshold of >0.5 appears to be more consistently supported and may provide a better predictor of future cardiometabolic risk in sub-Saharan Africa.
•Obesity & CVD are increasing rapidly in Africa.•Low cost measures are needed to find those at risk.•Debate continues on the optimum Waist Circumference threshold for African adults.•Waist-to-height ratio predicts current & future CVD risk in South-African adults.•There is greater global agreement on the WHtR threshold (>0.5) for risk.
URI
http://hdl.handle.net/10394/15841https://www.nmcd-journal.com/article/S0939-4753(14)00074-X/fulltext
https://doi.org/10.1016/j.numecd.2014.02.005
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- Faculty of Health Sciences [2385]