Comparative evaluation of anthropometric measures to predict cardiovascular risk factors in Tehranian adult women

Objective: To compare the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict cardiovascular risk factors in an urban adult population of Tehranian women. Design: Population-based cross-sectional study. Setting: Tehran, the capital of Iran. Subjects: This study was conducted on 5073 women aged 18-74 years, participants of the Tehran Lipid and Glucose Study. Demographic data were collected. Anthropometric indices were measured according to standard protocols. Cut-off points of BMI, WC, WHR and WHtR were considered as 25 kg m(-2), 80 cm, 0.8 and 0.5, respectively. Blood pressure was measured and hypertension was defined based on the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Biochemical analyses were conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose g126 mg dl(-1) or 2-hour plasma glucose g200 mg dl(-1) and dyslipidaemia based on the third report of the National Cholesterol Education Program Expert Panel. The presence of 'at least one risk factor' from the three major cardiovascular risk factors (hypertension, dyslipidaemia and diabetes) was also evaluated. Results: Mean (+/- standard deviation) age of women was 39.9 +/- 14.6 years; mean BMI, WC, WHR and WHtR were 27.1 +/- 1.5 kg m(-2), 86.5 +/- 13.5 cm and 0.83 +/- 0.08 and 0.55 +/- 0.08, respectively. Of the four anthropometric measures, WC had the highest sensitivity and specificity to identify subjects with risk factors in both the 18-39 year and the 40-74 year age categories. WC was seen to have a higher percentage of correct prediction than BMI, WHR and WHtR. Conclusion: It is concluded that WC is the best screening measure for cardiovascular risk factors, compared with BMI, WHR and WHtR, in Tehranian adult women.