Differential association of anthropometric parameters with coronary risk in women--data of the CORA study

The predictive value of weight gain, BMI, waist circumference (WC) and waist-to-hip ratio (WHR) as to cardiovascular risk factors and coronary heart disease (CHD) is still controversial.

200 consecutive pre- and postmenopausal women with incident CHD (cases) were compared with 255 randomized age-matched population-based controls recruited from corresponding neighborhoods of Hamburg between 1997 and 2001.

At the time of recruitment cases and controls did not differ in BMI, but at any BMI in WC and WHR. Both parameters of central obesity were related to coronary risk. However, after adjustment for conventional risk factors, the odds ratio of WC for CHD lost its significance while the odds ratio of WHR was still 2.20 per 0.1 unit (95% confidence interval 1.48-3.27; p = 0.0001). The pattern of weight gain differed considerably in women with WHR ≥0.85 or <0.85 and closely matched that of women with or without CHD. The dietary pattern did not distinguish women with elevated WC or WHR.

In women, an elevated WHR was closely associated with the risk for CHD independent of BMI and conventional risk factors over and above an elevated WC. An increased WC predominantly seems to reflect the presence of components of the metabolic syndrome.