The waist-to-body mass index ratio as an anthropometric predictor for cardiovascular outcome in subjects with established atherosclerotic cardiovascular disease
Journal
Scientific reports
Journal Volume
12
Journal Issue
1
Pages
804
ISSN
2045-2322
Date Issued
2022-12
Author(s)
Hsuan, Chin-Feng
Lee, Thung-Lip
Tseng, Wei-Kung
Yin, Wei-Hsian
Yeh, Hung-I
Chen, Jaw-Wen
Wu, Chau-Chung
Lee, Yi-Heng
Hsuan, Chin-Feng
Lin, Fang-Ju
Lee, Thung-Lip
Yang, Kai-Chien
Tseng, Wei-Kung
Wu, Yen-Wen
Yin, Wei-Hsian
Yeh, Hung-I.
Chen, Jaw-Wen
Lee, Yi-Heng
Sheu, Huey-Herng
Hsieh, I.-Chang
Liu, Ming-En
Chen, Chen-Huan
Yeh, Hung-I.
Sung, Shih-Hsien
Liu, Ping-Yen
Wang, Zhi-Hong
Chiu, Kuan-Ming
Kuo, Chi-Tai
Hung, Chung-Lieh
Wang, Chun-Chieh
Chu, Pao-Hsien
Chen, Zhih-Cherng
Chang, Kuan-Cheng
Abstract
Obesity is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, 'obesity paradox' is observed in patients with coronary artery disease while defining obesity by body mass index (BMI). The purpose of this study is to identify a better anthropometric parameter to predict cardiovascular events in patients with ASCVD. The study was conducted using the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry. A total of 6,920 adult patients with stable ASCVD, enrolled from January 2010 to November 2014, were included, with a mean age of 65.9 years, 73.9% males, and a mean BMI of 26.3 kg/m2 at baseline. These patients were followed up for a median of 2.5 years. The study endpoint was the composite major adverse cardiovascular event (MACE), defined as cardiovascular death, nonfatal myocardial infarction or stroke, or cardiac arrest with resuscitation. Multivariable Cox proportional hazards regression showed a significant positive association between waist-to-BMI ratio and MACE (adjusted hazard ratio 1.69 per cm‧m2/kg increase in waist-to-BMI ratio, 95% CI 1.12-2.49, p = 0.01) after adjusting for potential risk factors and confounders. Traditional anthropometric parameters, such as BMI, weight, waist and waist-hip ratio, or newer waist-based indices, such as body roundness index and a body shape index, did not show any significant linear associations (p = 0.09, 0.30, 0.89, 0.54, 0.79 and 0.06, respectively). In the restricted cubic spline regression analysis, the positive dose-response association between waist-to-BMI ratio and MACE persisted across all the range of waist-to-BMI ratio. The positive dose-response association was non-linear with a much steeper increase in the risk of MACE for waist-to-BMI ratio > 3.6 cm‧m2/kg. In conclusion, waist-to-BMI ratio may function as a positive predictor for the risk of MACE in established ASCVD patients.
Subjects
CORONARY-ARTERY-DISEASE; VISCERAL ADIPOSE-TISSUE; METABOLIC SYNDROME; ABDOMINAL OBESITY; HIP CIRCUMFERENCE; RISK; FAT; ASSOCIATION; MORTALITY; EVENTS
SDGs
Publisher
NATURE PORTFOLIO
Type
journal article