Comparative Evaluation of Waist-to-Height Ratio and BMI in Predicting Adverse Cardiovascular Outcome in People With Diabetes: A Systematic Review

Abstract

Central obesity is strongly associated with cardiovascular risk in people with diabetes. BMI does not reflect a regional fat distribution. The other anthropometric indices, which are markers of central obesity, like waist circumference and waist-hip ratio, are subject to age, sex, and ethnic variations. An index like waist-toheight ratio (WHtR), which considers central obesity, outperforms BMI in predicting cardiometabolic risk. With a single cut-off of 0.5, irrespective of age, sex, and ethnic variations, WHtR has a wide application in screening obesity in population settings. Previous systematic analyses were conducted in the general population, assessing cardiometabolic risk. The current study is the first systematic analysis to compare the applicability of WHtR and BMI in predicting both cardiovascular risk and adverse cardiovascular outcomes in people with diabetes. It includes prospective cohort studies, cross-sectional studies, and randomized control trials to generate evidence. The summary scores indicate that WHtR is probably a better indicator than BMI to assess cardiovascular risk in people with diabetes. A future meta-analysis will pave the way for more robust evidence.

Adipose Dysfunction Indices as a Key to Cardiometabolic Risk Assessment—A Population-Based Study of Post-Myocardial Infarction Patients

“…In contrast, the BMI was not found to be superior to the WHtR in any of the studies reviewed by the authors. The case for the practical implementation of the WHtR is additionally reinforced by the fact that the index is simple and condensed into an easy-to-remember phrase: “keep your waist to less than half your height” [ 34 ]. In the context of predicting the development of metabolic syndrome, WHtR was notably superior to the BMI and waist circumference (WC) across all age groups, demonstrating its versatility as a predictive tool for cardiometabolic risk in diverse populations [ 35 ].…”

Anthropometric Indices in Predicting the Risks of Occurrence and Outcomes of Diseases at Present Stage

“…Исследование A. Tewari с соавт. [38] является первым систематическим анализом, сравнивающим применимость и сопоставимость индекса отношения объема талии к росту и ИМТ для прогнозирования как сердечнососудистых рисков, так и неблагоприятных сердечно-сосудистых исходов у пациентов с диабетом. Авторы приводят данные, что индекс «объем талии/рост», по их мнению, является лучшим, чем ИМТ индикатором для оценки сердечно-сосудистых рисков у людей с диабетом.…”