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Anthropometric assessment of abdominal obesity and coronary heart disease risk in men : the PRIME study
  1. Elise Gruson
  1. Institut Pasteur de Lille, France
    1. Michèle Montaye
    1. Institut Pasteur de Lille, France
      1. Frank Kee
      1. Queen's University, United Kingdom
        1. Aline Wagner
        1. Université Louis Pasteur, France
          1. Annie Bingham
          1. INSERM, France
            1. Jean-Bernard Ruidavets
            1. Faculté de Médecine Purpan, France
              1. Bernadette Haas
              1. Université Louis Pasteur, France
                1. Alun Evans
                1. Queen's University, United Kingdom
                  1. Jean Ferrières
                  1. Faculté de Médecine Purpan, France
                    1. Pierre Ducimetière
                    1. INSERM, France
                      1. Philippe Amouyel
                      1. Institut Pasteur de Lille, France
                        1. Jean Dallongeville (jean.dallongeville{at}pasteur-lille.fr)
                        1. Institut Pasteur de Lille, France

                          Abstract

                          Objective: Waist-to-height ratio is an anthropometric indicator of abdominal obesity that accounts for stature. Earlier studies have reported marked associations between the waist-to-height ratio and cardiovascular risk factors. The goal of this study was to compare the associations of waist-to-height ratio, waist girth or waist-to-hip ratio and coronary events incidence.

                          Design: Prospective study with 10,602 men, aged 50 to 59 years old, recruited between 1991 and 1993 in 3 centres in France and 1 centre in Northern Ireland. Clinical and biological data were obtained at interview by trained staff. During the 10 years of follow-up 659 incident coronary events (CHD) were recorded. The relationships between anthropometric markers and coronary events were estimated by Cox proportional hazards models.

                          Results: Waist circumference, waist-to-hip ratio and waist-to-height ratios were positively associated with blood pressure (p<0.0001), diabetes (p<0.0001), LDL-cholesterol (p<0.0001), triglycerides (p<0.0001) and inversely correlated to HDL-cholesterol (p<0.0001). There was a linear association between waist circumference, waist-to-hip ratio and waist-to-height ratio and CHD events. The age and centre-adjusted relative risk [95% CI] for CHD were 1.57 [1.22-2.01], 1.75 [1.34-2.87], 2.3 [1.79-2.99] and 1.99 [1.54-2.56] in the 5th quintile vs. the first quintile of waist circumference, waist-to-hip ratio, waist-to-height ratio and BMI distribution, respectively. After further adjustment for school duration, physical activity, tobacco and alcohol consumption, hypertension, diabetes, HDL-cholesterol and triglycerides, the relative risks for CHD were 0.99 [0.76-1.30] for waist circumference (p=0.5), 1.22[0.93-1.60] for waist-to-hip ratio (p=0.1), 1.53[1.16-2.01] for waist-to-height ratio (p=0.03) and 1.30 [0.99-1.71] for BMI (p=0.06).

                          Conclusion: In middle-aged European men, waist-to-height ratio identifies coronary risk more strongly than waist circumference, waist-to-hip ratio or BMI, though the difference is marginal.

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