DOC News October 1, 2005
Volume 2 Number 10 p. 10
© 2005 American Diabetes Association
Finding the Best Obesity Measure for Heart-Disease Risk
Waist-to-height ratio may be better than BMI
A group of German researchers reports that the ratio of waist circumference
to tallness is the measure that stands above all others in terms of indicating
obesity-related cardiovascular risk.
Overweight and obesity are widely recognized as risks for cardiovascular
disease, along with a variety of comorbidities. There are a number of methods
for measuring body size, some invested with more importance than others, and
all with their proponents and detractors.
Body mass index (BMI) has been established as one standard measure of
overweight and obesity. In recent years, waist circumference has emerged as a
useful tool to assess the distribution of body weight, a measurement that some
experts say is more sensitive to central or abdominal obesity.
The measurement of waist-to-tallness ratio (WTR) "is simple and the
most reliable predictor of cardiovascular risk in primary care," says
endocrinology fellow Harald Schneider, MD, who presented the results of the
German study at the annual meeting of The Endocrine Society in June in San
Diego. He suggests its regular use in primary care.
The investigators, from Max Planck Institute of Psychiatry in Munich and
the University of Dresden, conducted a clinical epidemiological study of
48,353 middle-aged primary care patients enrolled in the Diabetes
Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of
Treatment (DETECT) Study. The group evaluated the predictive value of BMI,
waist circumference, hip circumference, waist-to-hip ratio (WHR), and WTR.
Male participants were 35–54 years of age, while females were
55–64 years. "This is the age group where you'd expect to see
cardiovascular disease," Schneider says.
All patients completed a standardized clinical and laboratory assessment by
their primary care physician, including diagnostic screening measures and a
questionnaire for patients. A sampling of 7,519 patients had more extensive
testing and was followed for a 12-month period.
Of all the body-size measures, WTR was the most sensitive to
"over-all cardiovascular disease risk" in both men and women,
followed by waist circumference and BMI, Schneider says. Analysis revealed a
cut-off point of 0.53 for women and 0.55 for men. 
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