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waist-to-hip ratio

Pathology: - the waist-to-hip ratio appears to be stronger predictor of mortality & cardiovascular mortality than body-mass index [1,2,3,6] - increased BMI, waist circumference or waist-to-hip ratio equally predictive of risk [4] - central obesity is associated with an increased risk of diabetes mellitus type 2, dysplipidemia, hypertension, & cardiovascular disease in overweight & obese patients [5,7] - abdominal obesity defined as a waist-to-hip ratio of < 0.9 in men & < 0.85 in women is associated with cognitive impairment [8] Genetics: - Thr-64 polymorphism in UCP1 gene is associated with an increased waist-to-hip ratio Management: - current guidelines propose cutoffs for waist-to-hip ratio of 0.9-1.0 for men & 0.85 for women [3]

Related

body mass index (BMI) cardiovascular risk factor waist circumference

References

  1. Yusuf S et al, Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries. Lancet 2005; 366:1640 PMID: 16271645 - Kragelumd & Omland T A farewell to body-mass index? Lancet 2005; 366:1589 PMID: 16271629
  2. Zhang X et al, Abdominal adiposity and mortality in Chinese women Arch Intern Med 2007, 167:886 PMID: 17502529 - Hu FB Obesity and mortality: Watch your waist, not just your weight. Arch Intern Med 2007, 167:875 PMID: 17502526
  3. Pischon T et al General and Abdominal Adiposity and Risk of Death in Europe N Engl J Med 2008 Nov 13; 359:2105. PMID: 19005195
  4. The Emerging Risk Factors Collaboration. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: Collaborative analysis of 58 prospective studies. Lancet 2011 Mar 26; 377:1085. PMID: 21397319
  5. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
  6. Sahakyan KR et al Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality. Ann Intern Med. Published online 10 November 2015 PMID: 26551006 http://annals.org/article.aspx?articleid=2468805 - Poirier P The Many Paradoxes of Our Modern World: Is There Really an Obesity Paradox or Is It Only a Matter of Adiposity Assessment? Ann Intern Med. Published online 10 November 2015 PMID: 26551376 http://annals.org/article.aspx?articleid=2468808
  7. Emdin CA, Khera AV, Natarajan P et al Genetic Association of Waist-to-Hip Ratio With Cardiometabolic Traits, Type 2 Diabetes, and Coronary Heart Disease. JAMA. 2017;317(6):626-634 PMID: 2819625 http://jamanetwork.com/journals/jama/article-abstract/2601502
  8. Lin Wy Associations of five obesity indicators with cognitive performance in 30,697 Taiwan Biobank participants. BMC Geriatrics. 2022 22:839. Nov 7 PMID: 36344931 https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-03457-x