AHA: Predictive Value of Waist Circumference and BMI Varies by Race

ORLANDO, Nov. 9 -- The value of waist circumference and BMI to predict cardiometabolic risk and Framingham global risk varied by race, researchers here reported.
Action Points
Explain to interested patients that this report provides additional evidence of the risk associated with central adiposity and obesity, but suggests that the risk may be attenuated by race.
Note that this study was published as an abstract and presented at a conference. The data and conclusions should be considered to be preliminary until published in a peer-reviewed publication.
Overall, waist circumference was a better predictor of elevated fasting glucose and C-reactive protein than BMI in a study of family members of patients hospitalized for heart disease, reported Lori Mosca, M.D., Ph.D., of Columbia University, at the American Heart Association meeting.
And, she added, BMI of 25 or more was the strongest overall predictor of elevated blood pressure, low HDL, elevated triglycerides, and a Framingham global risk score of 10% or higher.
But when she and colleagues stratified the results by race, waist circumference was not a significant predictor of elevated fasting glucose for non-whites. Likewise, BMI was not a significant predictor of low HDL (P0.01 compared with whites).
The findings, nonetheless, affirm the need to include both waist circumference and BMI in screening guidelines, Dr. Mosca said.
The Family Intervention Trial for Heart Health (FIT) enrolled 472 adult family members of hospitalized heart disease patients. The mean age of participants was 48 ± 14 years, 67% were women, and a little more than a third were non-white minorities.
The researchers measured height, weight, waist circumference, BMI, blood pressure, HDL, triglycerides, fasting glucose, and C-reactive protein.
Compared with individuals with slimmer waists, women with waists of more than 35 inches and men whose girth exceeded 40 inches had an odds ratio of 1.84 for fasting glucose of more than 100 mg/dL. For elevated CRP, the OR was 4.88 (P0.05). Among whites, the ORs were higher still -- 1.90 for elevated fasting glucose and 5.84 for elevated CRP (P0.05 versus thinner whites).
Overall, waist circumference was also a significant predictor of blood pressure of 140/90 mm Hg or higher (OR: 1.91), low HDL (OR: 2.96), and triglycerides of 150 mg/dL or higher (OR: 2.59) (P0.05 for all). It was not a significant predictor of elevated Framingham global risk (10% or higher).
Overall, BMI was a significant predictor of elevated blood pressure (OR: 3.20), low HDL (OR: 5.49), high triglycerides (OR: 5.23), elevated glucose (OR: 1.76), elevated CRP (OR: 3.68), and Framingham global risk score of 10% or higher (OR: 3.57) (P0.05 for all).
The study was supported by the National Heart, Lung, and Blood Institute. Dr. Mosca disclosed financial support from Abbott Laboratories, Bayer Corporation, Bristol-Myers Squibb, Cholestech Corporation, Kos Pharmaceuticals, Eli Lilly Research Laboratories, Merck, Novartis, Organon, Pharmacia, Pfizer, Inc., Reliant, Sankyo, and Wyeth-Ayerst.Primary source: American Heart Association MeetingSource reference: Christian AH, et al "Waist Circumference, Body Mass Index, and their Association with Cardiometabolic and Global Risk Among Whites and Racial/Ethnic Minorities" AHA Meeting 2007; Abstract 3551.