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Abdominal obesity and coronary heart disease in Thai men
Wichai Aekplakorn1, Varapat Pakpeankitwatana, Crystal M Y Lee
1Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
Insights
The waist-to-height ratio (WHtR) is the most effective simple anthropometric index for predicting coronary heart disease (CHD) in Thai men. This study identified optimal cut-off points for WHtR to aid in early CHD risk assessment.
Area of Science:
- Cardiology
- Public Health
- Anthropometry
Background:
- Coronary heart disease (CHD) poses a significant health burden.
- Simple anthropometric indices are valuable for assessing CHD risk.
- Predictive accuracy of these indices in Thai men requires further investigation.
Purpose of the Study:
- To assess the association between four anthropometric indices and CHD risk in Thai men.
- To determine optimal cut-off points for these indices in predicting CHD.
- To compare the predictive performance of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).
Main Methods:
- A 17-year cohort study involving 2536 Thai men aged 35-59.
- Measurement of height, weight, waist, and hip circumference.
- Analysis using Cox regression and receiver operating characteristic (ROC) curves.
Main Results:
- Waist-to-height ratio (WHtR) showed the strongest association with CHD events.
- The highest WHtR group had a significantly elevated hazard ratio (2.89) compared to the lowest.
- WHtR demonstrated the largest area under the ROC curve (AUC), suggesting superior discrimination.
Conclusions:
- WHtR is marginally the best among the four indices for predicting CHD in Thai men.
- The optimal cut-off for WHtR was estimated at 0.51.
- While WHtR performed best, differences in AUC among the indices were not statistically significant.
Objective:
To determine the association of four simple anthropometric indices with coronary heart disease (CHD) in Thai men, and to determine the optimal cut-off points for each index in the prediction of CHD.
Research Methods And Procedures:
This is a cohort study with 17 years of follow-up. A total of 2536 male employees from the Electricity Generating Authority of Thailand 35 to 59 years of age at baseline were included in the study. Height, weight, waist circumference, and hip circumference were measured to generate BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Cox regression models were used to estimate hazard ratios by thirds of each index. Receiver operating characteristic curves were used to assess discrimination of CHD.
Results:
WHtR was most strongly associated with CHD events in Thai men. The age-adjusted hazard ratio for those in the highest, compared with the lowest, third was 2.89 (1.37, 6.11). Although WHtR had the largest area under the receiver operating characteristic curve (AUC) with the optimal cut-off estimated to be 0.51 (sensitivity, 55%; specificity, 61%), no statistically significant difference (p>0.10) was found between the AUC for WHtR and that for the other three indices.
Conclusion:
WHtR is, marginally, the best of the four indices considered to predict CHD events in Thai men.
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