Waist-to-height ratio, waist circumference, body mass index, waist divided by height(0.5) and the risk of cardiometabolic multimorbidity: A national longitudinal cohort study.

Cardiometabolic multimorbidity (CM) is an increasing public health burden. This study aimed to evaluate the association of waist-to-height ratio (WHtR), waist circumference (WC), waist divided by height0.5 (WHT.5R) and body mass index (BMI) with the risk of CM. We used data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10,521 participants aged 45 years and over were recruited, including 8807 individuals with 0 cardiometabolic diseases at baseline (stage I) and 1714 individuals with 1 cardiometabolic disease at baseline (stage II). CM was defined as self-reporting of two or more of the following conditions: stroke, diabetes and heart disease. Logistic regression was conducted to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the incremental predictive value beyond conventional factors. In stage I, an increased risk of CM was observed among participants with WHtR ≥0.5 (OR: 1.76, 95% CI: 1.05-2.97), WC ≥ 90 cm (men) + WC ≥ 80 cm (women) (OR: 2.06, 95% CI: 1.29-3.27), WHT.5R ≥ 6.54 cm0.5 (OR: 1.81, 95% CI: 1.16-2.83) or BMI ≥24 kg/m2 (OR: 1.48, 95% CI: 0.98-2.24). Furthermore, the NRI and IDI of WHtR, WC and WHT.5R were all higher than those of BMI. In stage II, the adjusted ORs (95% CIs) of WHtR, WC, WHT.5R and BMI were 2.04 (1.24-3.35), 1.89 (1.29-2.77), 1.86 (1.24-2.78) and 1.47 (1.06-2.04), respectively. In addition, WC exhibited the highest NRI and IDI. WHtR, WC, WHT.5R and BMI are independent predictors of CM in the middle-aged and older Chinese population. WHtR, WC and WHT.5R show better abilities in predicting CM than BMI.

Lu Y ，Liu S ，Qiao Y ，Li G ，Wu Y ，Ke C ... -  《-》

Association of anthropometric indices with the development of multimorbidity in middle-aged and older adults: A retrospective cohort study.

Geng S ，Chen X ，Shi Z ，Bai K ，Shi S ... -  《-》

Association of adiposity indices with cardiometabolic multimorbidity among 101,973 chinese adults: a cross-sectional study.

Cardiometabolic multimorbidity (CMM) and obesity represent two major health problems. The relationship between adiposity indices and CMM, however, remains understudied. This study aimed to investigate the associations of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) with CMM among Chinese adults. Data of 101,973 participants were collected from a population-based screening project in Southern China. CMM was defined as having two or more of the following diseases: coronary heart disease, stroke, hypertension, and diabetes. The relationship between the six adiposity indices and CMM was investigated by multivariate logistic regression and restricted cubic splines. Receiver operator characteristic curve, C-statistic and net reclassification index were used to estimate the discriminative and incremental values of adiposity indices on CMM. Logistic regression models showed the six adiposity indices were all significantly associated with the odds of CMM with non-linear relationships. For per SD increment, WC (Odds ratio [OR]: 1.66; 95% confidence interval (CI): 1.62-1.70) and WHtR (OR, 1.61; 95% CI, 1.58-1.65) were more significantly associated with a higher prevalence of CMM than BMI (OR, 1.55; 95% CI, 1.52-1.58) (all P < 0.05). In addition, WC, WHtR, and BRI displayed significantly better performance in detecting CMM compared with BMI (all P < 0.05). Their respective area under the curve (AUC) values were 0.675 (95% CI: 0.670-0.680), 0.679 (95% CI: 0.675-0.684), and 0.679 (95% CI: 0.675-0.684), while BMI yielded an AUC of 0.637 (95% CI: 0.632-0.643). These findings hold true across all subgroups based on sex and age. When Adding WC, WHtR, or BRI to a base model, they all provided larger incremental values for the discrimination of CMM compared with BMI (all P < 0.05). Adiposity indices were closely associated with the odds of CMM, with WC and WHtR demonstrating stronger associations than BMI. WC, WHtR, and BRI were superior to BMI in discriminative ability for CMM. Avoidance of obesity (especially abdominal obesity) may be the preferred primary prevention strategy for CMM while controlling for other major CMM risk factors.

Qin X ，Chen C ，Wang J ，Cai A ，Feng X ，Jiang X ，Feng Y ... -  《-》

Optimised anthropometric indices as predictive screening tools for metabolic syndrome in adults: a cross-sectional study.

We aimed to evaluate the association between metabolic syndrome (MetS) and two latest optimised indices, waist divided by height 0.5 (WHT.5R) and body mass index (BMI) multiply by the square root of BMI and waist circumference (BMI√WC), and to comprehensively compare the ability of 10 anthropometric indices to identify MetS, including BMI√WC, WHT.5R, abdominal volume index (AVI), waist-to-height ratio (WHtR), Body Roundness Index (BRI). Cross-sectional study. Ningxia, China. A total of 3860 adults aged 18-88 years from Ningxia, China were recruited by a single stratified cluster random sampling method. ORs and 95% CIs for associations between indices and MetS were calculated using binary logistic regression, and areas under the receiver operating characteristic (ROC) curves (AUCs) were performed to compare their predictive capacity for MetS. All results for men and women were analysed and presented separately. The highest adjusted ORs for MetS were observed for the following indices: AVI (OR 15.22, 95% CI 10.88 to 21.30), WHT.5R (OR 13.83, 95% CI 9.89 to 19.35) and BMI√WC (OR 12.14, 95% CI 8.79 to 16.76) in men, whereas BRI, WHtR (both OR 14.91, 95% CI 10.39 to 21.4), WHT.5R (OR 14.22, 95% CI 9.96 to 20.29) and AVI (OR 14.03, 95% CI 9.91 to 19.87) in women. In ROC analysis, AVI (AUC: 0.767 for men and 0.749 for women) and WHT.5R (AUC: 0.761 for men and 0.747 for women) showed the highest predictive ability for MetS. BMI√WC and WHT.5R were significantly positively associated with MetS, and AVI and WHT.5R could be useful screening tools for identifying MetS in both sexes.

Wu Y ，Li H ，Tao X ，Fan Y ，Gao Q ，Yang J ... -  《-》

Waist-to-height ratio is an appropriate index for identifying cardiometabolic risk in Chinese individuals with normal body mass index and waist circumference.

The waist-to-height ratio (WHtR), a novel index that has been reported to correlate more strongly than body mass index (BMI) and waist circumference (WC) with cardiometabolic risk factors, has not been studied in Chinese individuals with normal body mass index and waist circumference. The present study compared the predictive power of WHtR with those of BMI and WC for such factors in non-obese Chinese, and to define optimal cutoffs of WHtR in this population. A total of 2137 subjects aged 40-75 years were recruited. Three anthropometric indices (WHtR, BMI, and WC) were compared and the optimal cutoffs of WHtR were identified by receiver operating characteristic curve (ROC) analysis. WHtR was divided into four quartiles (WHtR-Q), and multiple linear regression analyses were used to calculate the relationship between WHtR-Q and clinical biochemical index. Waist-to-height ratio was more efficient than WC to identify cardiometabolic risk factors in both genders, but was only superior to BMI in females. WHtR-Q was positively correlated with fasting plasma glucose, 2-h postprandial blood glucose, and systolic blood pressure, and negatively connected with high density lipoprotein cholesterol in both genders after controlling for age, current smoking and drinking, moderate-intensity physical activity, daily sedentary time, daily screen time and menopause (only for females). The optimal cutoffs of WHtR for detecting cardiometabolic risk factors were 0.47 in males and 0.51 in females. Waist-to-height ratio might be an effective index to identify cardiometabolic risk factors in Chinese with normal BMI and WC, particularly in females.

Zhu Q ，Shen F ，Ye T ，Zhou Q ，Deng H ，Gu X ... -  《-》