Cited by 2,130Diabetes, Cardiovascular Risks, and LipoproteinsBody Composition Measurement TechniquesObesity, Physical Activity, Diet

Waist‐to‐height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta‐analysis

Ashwell, M., Gunn, P., Gibson, S.·2012·Obesity Reviews

Abstract

Summary: Our aim was to differentiate the screening potential of waist‐to‐height ratio (WHtR) and waist circumference (WC) for adult cardiometabolic risk in people of different nationalities and to compare both with body mass index (BMI). We undertook a systematic review and meta‐analysis of studies that used receiver operating characteristics (ROC) curves for assessing the discriminatory power of anthropometric indices in distinguishing adults with hypertension, type‐2 diabetes, dyslipidaemia, metabolic syndrome and general cardiovascular outcomes (CVD). Thirty one papers met the inclusion criteria. Using data on all outcomes, averaged within study group, WHtR had significantly greater discriminatory power compared with BMI. Compared with BMI, WC improved discrimination of adverse outcomes by 3% ( P < 0.05) and WHtR improved discrimination by 4–5% over BMI ( P < 0.01). Most importantly, statistical analysis of the within‐study difference in AUC showed WHtR to be significantly better than WC for diabetes, hypertension, CVD and all outcomes ( P < 0.005) in men and women. For the first time, robust statistical evidence from studies involving more than 300 000 adults in several ethnic groups, shows the superiority of WHtR over WC and BMI for detecting cardiometabolic risk factors in both sexes. Waist‐to‐height ratio should therefore be considered as a screening tool.

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Crossref · 10.1111/j.1467-789x.2011.00952.x

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Authors
Ashwell, M., Gunn, P., & Gibson, S.
Affiliations
Oxford Brookes University (GB)
Corresponding author
Ashwell, M.
Venue
Obesity Reviews
Publisher
Wiley
Published
2011-11-23
Volume
13
Issue
3
Pages
275-286
ISSN
  • 1467-7881 (ISSN-L)
  • 1467-789X
OpenAlex
W1574715084
Cited by
2,130
References
1
Citations by year
2026: 214 · 2025: 222 · 2024: 179 · 2023: 179 · 2022: 161 · 2021: 161 · 2020: 189 · 2019: 143 · 2018: 133 · 2017: 113 · 2016: 139 · 2015: 103 · 2014: 97 · 2013: 72 · 2012: 21
FWCI
8.62
Type
journal article
Language
en
Open access
closed
Locations
  • Obesity Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Open Research (University of Surrey) (submittedVersion)
  • Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
waist-to-height ratio, waist circumference, body mass index, cardiometabolic risk, cardiovascular risk screening, hypertension, type 2 diabetes, dyslipidemia, metabolic syndrome, cardiovascular outcomes, anthropometric indices, ethnic differences, sex differences
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Body Height, Cardiovascular Diseases, Female, Humans, Male, Mass Screening, Middle Aged, Obesity, ROC Curve, Body Mass Index, Waist Circumference, Young Adult

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