Comparison of waist circumference and waist‐to‐height ratio as predictors of clustering of cardiovascular risk factors among middle‐aged people in rural Khanh Hoa, Vietnam

• Published in: American journal of human biology Vol. 36; no. 8; pp. e24063 - n/a
• Main Authors: Shrestha, Rachana Manandhar, Pham, Thuy Thi Phuong, Yamamoto, Shohei, Nguyen, Chau Que, Fukunaga, Ami, Danh, Phan Cong, Hachiya, Masahiko, Le, Huy Xuan, Do, Hung Thai, Mizoue, Tetsuya, Inoue, Yosuke
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.08.2024; Wiley Subscription Services, Inc
• Subjects: Adult; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cluster Analysis; Clustering; Diabetes mellitus; Dyslipidemia; Female; Health risks; Heart Disease Risk Factors; Heart diseases; Humans; Hypertension; Male; Middle Aged; Older people; Performance prediction; Risk Factors; Rural areas; Rural Population - statistics & numerical data; Rural populations; Vietnam - epidemiology; Waist Circumference; Waist-Height Ratio; Women; Vietnam
• ISSN: 1042-0533; 1520-6300; 1520-6300
• DOI: 10.1002/ajhb.24063

Objective Given the population‐level variation in stature, a universal cut‐off for waist circumference (WC) may not be appropriate for some populations. We compared the performance of WC and waist‐to‐height ratio (WHtR) to detect the clustering of cardiovascular disease (CVD) risk factors in rural Vietnam. Methods We obtained data from a baseline survey of the Khanh Hoa Cardiovascular Study comprising 2942 middle‐aged residents (40–60 years). We used areas under the receiver operating characteristics curve (AUROC), net reclassification index (NRI), and integrated discrimination improvement (IDI) to compare the performance of WC and WHtR in predicting CVD risk clustering (≥2 of the following risk factors: hypertension, diabetes, dyslipidemia, and elevated C‐reactive protein). Results The optimal cut‐off values for WC were 81.8 and 80.7 cm for men and women, respectively. Regarding the clustering of CVD risk factors, the AUROC (95% CI) of WC and WHtR were 0.707 (0.676 to 0.739) and 0.719 (0.689 to 0.749) in men, and 0.682 (0.654 to 0.709) and 0.690 (0.663 to 0.717) in women, respectively. Compared with WC, WHtR had a better NRI (0.229; 0.102–0.344) and IDI (0.012; 0.004–0.020) in men and a better NRI (0.154; 0.050–0.257) in women. Conclusions The optimal WC cut‐off for Vietnamese men was approximately 10 cm below the recommended Asian cut‐off. WHtR might perform slightly better in predicting the clustering of CVD risk factors among the rural population in Vietnam.