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To evaluate the performance of waist-to-height ratio (WHtR) in predicting
cardiometabolic outcomes and compare cut-off points for Brazilian
Cross-sectional study. WHtR areas under the curve (AUC) were compared with
those for BMI, waist circumference (WC) and waist-to-hip ratio (WHR). The
outcomes of interest were hypertension, diabetes, hypertriacylglycerolaemia
and presence of at least two components of metabolic syndrome (≥2
MetS). Cut-offs for WHtR were compared and validity measures were estimated
for each point.
Teaching and research institutions in six Brazilian state capitals,
Women (n 5026) and men (n 4238) aged
35–54 years who participated in the Brazilian Longitudinal Study of
Adult Health (ELSA-Brasil) at baseline.
WHtR age-adjusted AUC ranged from 0·68 to 0·72 in men and
0·69 to 0·75 in women, with smaller AUC for
hypertriacylglycerolaemia and the largest for ≥2 MetS. WHtR performed
better than BMI for practically all outcomes; better than WHR for
hypertension in both sexes; and displayed larger AUC than WC in predicting
diabetes mellitus. It also offered better discriminatory power for ≥2
MetS in men; and was better than WC, but not WHR, in women. Optimal cut-off
points of WHtR were 0·55 (women) and 0·54 (men), but they
presented high false-negative rate compared with 0·50.
We recommend using WHtR (which performed similarly to, or better than, other
available indices of adiposity) as an anthropometric index with good
discriminatory power for cardiometabolic outcomes in Brazilian adults,
indicating the already referenced limit of WHtR≥0·50.
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