Diagnostic value of waist-height ratio to predict cardiovascular disease risk in adults

https://doi.org/10.22146/bkm.52439

Laeli Ardiani Putri(1*), Neni Trilusiana(2), Hasanah Mumpuni(3)

(1) Public Health Master Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada
(2) Department of Health Nutrition, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta
(3) Cardiovascular Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Purpose: This study aimed to determine the diagnostic strength, optimal cutoff point, and diagnostic value of waist circumference/body height ratio in detecting cardiovascular disease risk in adults with Framingham Risk Score (FRS).

Method: This study used a cross-sectional research design using secondary data from the Fourth Wave of the Indonesian Family Life Survey 4 (IFLS 4). Subject selection uses the total sampling method so that the entire study population that matches the inclusion and exclusion criteria will be the subject of this study. The number of research subjects that fit the inclusion and exclusion criteria was 9,103 people. This research uses ROC analysis, with the gold standard is the risk of cardiovascular disease based on FRS, and the independent variable is WtHR.

Results: Based on sex, the risk of cardiovascular disease in the moderate category was higher in men (80.54%) compared to women (30.23%). AUC WtHR value in male subjects was 0.5817 (95% CI 0.5610-0.624), while the AUC value in female subjects was 0.5904 (CI 0.5727-0.6084). The optimal cutoff point in male subjects is 0.5249 (sens = 0.3549; spe = 0.7626), while the cut point in female subjects is 0.5796 (sens = 0.4382; spe = 0.7024).

Conclusion: The WtHR cutoff value based on this study is 0.5249 and 0.5796, so the health message that can be given to the public to prevent the risk of cardiovascular disease is to keep the waistline less than half the height.


Keywords


diagnostic test; waist circumference/height ratio; cardiovascular disease; IFLS

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References

  1. WHO. Cardiovascular diseases. In: World Health Organization (WHO) [Internet]. 2017 [cited 16 Oct 2020]. Available: http://www.who.int/cardiovascular_diseases/en/
  2. Kemenkes RI. Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan, Departemen Kesehatan, Republik Indonesia. 2013.
  3. Kemenkes RI. Hasil Utama Riset Kesehatan Dasar 2018. 2018.
  4. Kemenkes RI. Infodatin: Situasi Kesehatan Jantung. Pusat Data dan Informasi Kementerian Kesehatan RI. 2014; 1–8.
  5. Selvarajah S, Kaur G, Haniff J, Cheong KC, Hiong TG, van der Graaf Y, et al. Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population. Int J Cardiol. 2014;176: 211–218.
  6. Ashwell M, Mayhew L, Richardson J, Rickayzen B. Waist-to-height ratio is more predictive of years of life lost than body mass index. PLoS One. 2014;9: e103483.
  7. Bastien M, Poirier P, Lemieux I, Després J-P. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis. 2014;56: 369–381.
  8. Ashwell M, Gibson S. Waist to height ratio is a simple and effective obesity screening tool for cardiovascular risk factors: Analysis of data from the British National Diet And Nutrition Survey of adults aged 19-64 years. Obes Facts. 2009;2: 97–103.
  9. Savva SC, Lamnisos D, Kafatos AG. Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis. Diabetes Metab Syndr Obes. 2013;6: 403–419.
  10. Dahlan MS. Penelitian diagnostik. Jakarta: Salemba Medika. 2009.
  11. Palmisano BT, Zhu L, Eckel RH, Stafford JM. Sex differences in lipid and lipoprotein metabolism. Mol Metab. 2018;15: 45–55.
  12. Caminha TCS, Ferreira HS, Costa NS, Nakano RP, Carvalho RES, Xavier AFS Jr, et al. Waist-to-height ratio is the best anthropometric predictor of hypertension: A population-based study with women from a state of northeast of Brazil. Medicine . 2017;96: e5874.
  13. Mellati AA, Mousavinasab SN, Sokhanvar S, Kazemi SAN, Esmailli MH, Dinmohamadi H. Correlation of anthropometric indices with common cardiovascular risk factors in an urban adult population of Iran: data from Zanjan Healthy Heart Study. Asia Pac J Clin Nutr. 2009;18: 217–225.
  14. Battie CA, Borja-Hart N, Ancheta IB, Flores R, Rao G, Palaniappan L. Comparison of body mass index, waist circumference, and waist to height ratio in the prediction of hypertension and diabetes mellitus: Filipino-American women cardiovascular study. Preventive Medicine Reports. 2016;4: 608–613.
  15. Mirmiran P, Esmaillzadeh A, Azizi F. Detection of cardiovascular risk factors by anthropometric measures in Tehranian adults: receiver operating characteristic (ROC) curve analysis. Eur J Clin Nutr. 2004;58: 1110–1118.
  16. Akobeng AK. Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta Paediatr. 2007;96: 338–341.
  17. Song X, Tabák AG, Zethelius B, Yudkin JS, Söderberg S, Laatikainen T, et al. Obesity attenuates gender differences in cardiovascular mortality. Cardiovasc Diabetol. 2014;13: 144.
  18. Winham SJ, de Andrade M, Miller VM. Genetics of cardiovascular disease: Importance of sex and ethnicity. Atherosclerosis. 2015;241: 219–228.
  19. Meseri R, Ucku R, Unal B. Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults. Public Health Nutr. 2014;17: 2246–2252.



DOI: https://doi.org/10.22146/bkm.52439

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