ANTHROPOMETRIC INDICES IN ASSOCIATION WITH CARDIOMETABOLIC RISK FACTORS: FINDINGS OF THE ISFAHAN HEALTHY HEART PROGRAM

BACKGROUND: Obesity is increasing worldwide, but the debate about the most valid index associated with its health hazards remains unresolved. This study aimed to compare four main anthropometric indices by gender, to determine the best index in predicting cardiometabolic risk factors and to find their cutoff values in the population studied. METHODS: This study was a cross-sectional community-based study performed on a representative sample of 12,514 adults (aged ≥19 years) selected via 2-stage random cluster sampling from 3 cities in Iran. Partial correlation and ROC curve analyzes were used to determine the best anthropometric indices and their cutoff values. RESULTS: The study population comprised 6123 males and 6391 females. In both genders, waist circumference (WC) had the highest correlation with cardiometabolic risk factors (6 of 8 risk factors in men and 7 of 8 risk factors in women). ROC analyses showed that in males, the largest area under curve (AUC) was obtained for waist-to-stature ration (WSR) in most risk factors (6 of the 10) followed by body mass index (BMI) and waist-to-height ratio (WHR) with largest AUC (3 of the 10). The corresponding figure for females was obtained for WSR (9 of the 10) followed by BMI and WHR (1 of 10). Optimal cutoff values computed for combination of 3 major risk factors (including diabetes mellitus, hypertension and dyslipidemia) revealed that in males and females, respectively, the cutoff values were 21.9 and 23.5 kg/m2 for BMI, 80.70 and 84.70 cm for WC, 0.85 and 0.86 for WHR and 0.47 and 0.53 for WSR. CONCLUSION: WSR could be a valid anthropometric index for predicting cardiometabolic risk factors, and it has less variation than other indices among populations with ethnic differences in body size and fat distribution.