Waist-to-Hip Ratio vs BMI: Which Better Predicts Heart Disease Risk?

Both general and central adiposity showed causal effects on coronary heart disease (CHD) and type 2 diabetes, according to the results of a recent study.

In the study, researchers used 97 independent single nucleotide polymorphisms (SNPs) for BMI and 49 SNPs for waist:hip ratio adjusted for BMI (WHRadjBMI) to conduct Mendelian randomization analyses in 14 prospective studies. Primary outcomes included coronary heart disease, type 2 diabetes, major strokes subtypes, and secondary analysis included 18 cardiometabolic traits.
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The findings showed that each increase of 1 standard deviation (SD) in WHRadjBMI was associated with a 48% excess risk for coronary heart disease, which was similar to results using BMI.

In addition, both BMI and WHRadjBMI measures showed similar effects for type 2 diabetes, with odds ratio (OR) of 1.82 for 1 SD increase in WHRadjBMI and OR of 1.98 for 1 SD increase in BMI. Higher left ventricular hypertrophy, glycemic traits, interleukin-6, and circulating lipids were also associated with both BMI and WHRadjBMI.

However, only WHRadjBMI was associated with an increased risk for ischemic stroke (OR 1.32), and was also associated with higher carotid intima-media thickness.

“Both general and central adiposity have causal effects on CHD and [type 2 diabetes]. Central adiposity may have a stronger effect on stroke risk,” the researchers concluded. “Future estimates of the burden of adiposity on health should include measures of central and general adiposity.”

—Melissa Weiss

Reference:

Dale C, Fatemifar G, Palmer T, et al. Causal association of adiposity and body fat distribution with coronary heart disease, stroke subtypes and type 2 diabetes: a mendelian randomization analysis [published online May 12, 2017]. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.116.026560.