Waist-to-hip ratio is better at predicting subclinical atherosclerosis than body mass index and waist circumference in postmenopausal women

Lee, Hyun Jung; Hwang, Soon Young; Hong, Ho Cheol; Ryu, Jee-Youl; Seo, Ji A; Kim, Sin Gon; Kim, Nan Hee; Choi, Dong Seop; Baik, Sei Hyun; Choi, Kyung Mook; Yoo, Hye Jin

doi:10.1016/j.maturitas.2014.12.015

Cited by 27 publications

(16 citation statements)

References 30 publications

(29 reference statements)

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“…The observed superior role of abdominal obesity over general obesity in predicting carotid plaque development echoed findings of previous cross-sectional studies among early postmenopausal Asian women that WHR is an independent risk factor for the presence of plaque and subclinical atherosclerosis over and above BMI (7,8). As is being increasingly recognized, WHR reflects visceral fat accumulation and central fat distribution more accurately than BMI (25), and it is more closely associated with vascular endothelial dysfunction (26), atrial stiffness (27), and adverse cardiovascular events (28).…”

Section: Discussionsupporting

confidence: 68%

“…Extensive research has identified a range of risk factors of carotid plaque development (2,5), of which the role of obesity is particularly relevant to postmenopausal women because of the substantial changes in body composition and fat distribution during the menopausal transition (6). Specifically, abdominal obesity, often reflected by a higher waist-hip ratio (WHR), has been found to be associated with subclinical atherosclerosis, especially the presence of carotid plaque, independent of general obesity defined by the BMI (5,7,8). Also, among postmenopausal women with normal BMI, a direct impact of visceral fat thickness on initial stages of atherosclerotic vascular damage was observed (9).…”

Section: Introductionmentioning

confidence: 99%

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Prospective Association of Obesity Patterns with Subclinical Carotid Plaque Development in Early Postmenopausal Chinese Women

Chung

et al. 2020

Obesity

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This study aimed to examine the prospective associations of general and abdominal obesity patterns with carotid plaque development among early postmenopausal Chinese women. Methods: A total of 518 postmenopausal women aged 50 to 64 years were recruited between 2002 and 2004 and were followed up at 3 years and 5 years. Carotid plaque was measured using B-mode ultrasonography, whereas general and abdominal obesity were defined as BMI ≥ 25 kg/m 2 and waist-hip ratio ≥ 0.85, respectively. Sociodemographic, lifestyle, mental health, disease history, and clinical measurements were also assessed for confounding control. Multivariable binary logistic regression analyses on plaque development at 5 years were performed among 322 women with no carotid plaque at baseline. Results: Over the 5-year follow-up period, 70 women (21.7%) developed carotid plaque. Baseline abdominal obesity independently predicted plaque development (adjusted odds ratio = 2.30; 95% CI: 1.15-4.60), but general obesity did not. Women with normal-weight abdominal obesity were more than twice as likely to develop carotid plaque (adjusted odds ratio = 2.43; 95% CI: 1.02-5.75) compared with women with no obesity, with their risk comparable to women with both general and abdominal obesity. Conclusions: Abdominal obesity was a critical predictor of subclinical carotid plaque development among early postmenopausal Chinese women. Policy makers should recognize the need to identify high-risk midlife women with normal-weight abdominal obesity in public health and clinical practice.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Prospective Association of Obesity Patterns with Subclinical Carotid Plaque Development in Early Postmenopausal Chinese Women

Chung

et al. 2020

Obesity

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“…These findings are supported by the literature. Several studies demonstrated that central obesity markers like WC, WHtR and WHR predict cardiovascular risk and hypertension better than BMI [17][18][19][20]. A stronger role of BMI in predicting risk for hypertension in women as compared to men has been reported in the study of Sakurai et al [21] but not in the study of Zhang et al [7].…”

Section: Anthropometric Markers and Hypertensionmentioning

confidence: 98%

Correlation of MRI-derived adipose tissue measurements and anthropometric markers with prevalent hypertension in the community

Lorbeer

Rospleszcz

Schlett

et al. 2018

Journal of Hypertension

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“…These results were generalized beyond the UK education system and converted to the corresponding number of years using ISCED harmonization guidelines 49 and dichotomized into 'college' (>=17 years) versus 'high school' education. Waist-to-hip ratio is a common index of central fat distribution 50 and used as a proxy of atherosclerotic burden in overweight individuals and postmenopausal women 51,52 . Genetic principal components were regressed out to account for differences in ethnicity within the sample; only the first 4 components were considered as these have been previously shown to capture most of the population structure.…”

Section: Clinical Variablesmentioning

confidence: 99%

Exogenous Sex Hormone Effects on Brain Microstructure in Women: A diffusion MRI Study in the UK Biobank

Nabulsi¹,

Lawrence²,

Santhalingam³

et al. 2020

Preprint

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This study used advanced diffusion-weighted MRI (dMRI) to examine the association between exogenous sex-hormone exposure and the brain’s white matter aging trajectories in a large population-based sample of women. To investigate the effect of pre- and post-menopausal sex hormones on brain aging, cross-sectional brain dMRI data from the UK Biobank was analyzed using 3 diffusion models: conventional diffusion tensor imaging (DTI), the tensor distribution function (TDF), and neurite orientation dispersion and density imaging (NODDI). Mean skeletonized diffusivity measures were extracted and averaged across the whole brain, including fractional anisotropy, isotropic volume fraction, intracellular volume fraction and orientation dispersion index. We used general linear models and fractional polynomial regressions to characterize age-related trajectories in white matter measures following hormone therapy (HT) and oral contraceptive (OC) use in women (HT analysis: N=8,301; OC analysis: N=8,913). Sex hormone treatment (HT and OC) was statistically associated with the aging trends in white matter measures. Estrogen therapy alone appeared to exert a neuroprotective effect on age-related white matter processes, compared to HT containing both estrogen and progestin therapy – which was associated with accelerated aging-related processes in women. These results support the hypothesis that exogenous sex hormone exposure may impact white matter aging; white matter metrics may also be sensitive to sex hormone levels in women. Furthermore, we discuss the necessity to test alternative models for lifespan trajectories beyond popular linear and quadratic models, especially when dealing with large samples. Fractional polynomial models may provide a more adaptive alternative to linear or quadratic models.

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Waist-to-hip ratio is better at predicting subclinical atherosclerosis than body mass index and waist circumference in postmenopausal women

Cited by 27 publications

References 30 publications

Prospective Association of Obesity Patterns with Subclinical Carotid Plaque Development in Early Postmenopausal Chinese Women

Prospective Association of Obesity Patterns with Subclinical Carotid Plaque Development in Early Postmenopausal Chinese Women

Correlation of MRI-derived adipose tissue measurements and anthropometric markers with prevalent hypertension in the community

Exogenous Sex Hormone Effects on Brain Microstructure in Women: A diffusion MRI Study in the UK Biobank

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