Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis

Abstract

Introduction Obesity is one of the main risk factors for cardiovascular disease (CVD) and cardiometabolic disease (CMD). Many studies have developed cutoff points of anthropometric indices for predicting these diseases. The aim of this systematic review was to differentiate the screening potential of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for adult CVD risk. Methods We used relevant key words to search electronic databases to identify studies published up to 2019 that used receiver operating characteristic (ROC) curves for assessing the cut-off points of anthropometric indices. We used a random-effects model to pool study results and assessed between-study heterogeneity by using the I 2 statistic and Cochran’s Q test. Results This meta-analysis included 38 cross-sectional and 2 cohort studies with 105 to 137,256 participants aged 18 or older. The pooled area under the ROC curve (AUC) value for BMI was 0.66 (95% CI, 0.63–0.69) in both men and women. The pooled AUC values for WC were 0.69 (95% CI, 0.67–0.70) in men and 0.69 (95% CI, 0.64–0.74) in women, and the pooled AUC values for WHR were 0.69 (95% CI, 0.66–0.73) in men and 0.71 (95% CI, 0.68–0.73) in women. Conclusion Our findings indicated a slight difference between AUC values of these anthropometric indices. However, indices of abdominal obesity, especially WHR, can better predict CVD occurrence.

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

“…In both rats and humans, VAT produced significantly more PAI-1 compared to SAT. These results are consistent with the observation that cardiovascular risk is most closely correlated with central obesity [ 157 ]. PAI-1 produced by adipocytes and vascular endothelium is involved in tissue expansion and angiogenesis necessary during adipose tissue development [ 158 ].…”

Visceral Adiposity index and atherogenic index of plasma as reliable indices to prediction of cardiovascular diseases in adults: A Cross-Sectional analysis from the Iranian RaNCD Cohort Data

“…Several studies have also shown that AIP has a positive association with non-alcoholic fatty liver disease (NAFLD), advanced subclinical coronary artery disease (CAD), atherosclerosis and obesity; and is a useful and reliable marker for predicting these diseases [6,23,25]. A study on 11,495 Chinese has shown a signi cant and positive linear relationship between AIP and the prevalence of ischemic stroke [5]. Similar to our ndings, A study in Malaysia showed that among lipid pro le, AIP was more positively correlated with TG and more negatively correlated with HDL-C, thus they consider AIP to be the strongest marker in predicting CVDs risk over other indices [24].…”

“…Reducing blood pressure and serum cholesterol can, indeed, effectively prevent or delay CVDs events [4].Thus, measuring the risk factors for prediction and early detection of disease can be useful. In a meta-analysis study (2020), CVDs prediction was reported based on simple anthropometric indices including waist circumference (WC), body mass index (BMI) and waist to hip ratio (WHR) [5].Accumulation of visceral fat and blood lipid also are among the numerous risk factors contributing to CVDs [6,7]. Amato et al (2010) introduced visceral adiposity index (VAI), which is a combination of WC, BMI, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) [8].…”

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“…A study on 9,746 participants found that BMI, WC and WHR indices were valid predictors of MetS risk in adult; and BMI had the highest predictive power (AUC: 0.78; 95%CI: 0.77, 0.80) [18]. Meta-analysis studies have also reported these indicators as a reliable tool for predicting CVDs and MetS [19,20].…”