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Anthropometric predictors of coronary heart disease in Chinese women

International Journal of Obesity volume 28, pages 734–740 (2004)Cite this article

Abstract

OBJECTIVE: To evaluate the associations of body size and fat distribution with incidence of coronary heart disease (CHD) in Chinese women.

DESIGN: Population-based, prospective cohort study.

SUBJECTS: A total of 67 334 women aged 40–70 y, who had no prior history of CHD, stroke, and cancer at study recruitment.

MEASUREMENTS: Weight, standing and sitting heights, circumferences of waist and hip, and ratios of the anthropometric measurements. Outcome: incidence of CHD (non-fatal myocardial infarction (MI) or fatal CHD).

RESULTS: After a mean follow-up of 2.5 y (168 164 person-years), there were 70 incident cases of CHD (49 non-fatal MIs and 21 CHD deaths). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-standing height ratio (WHtR), waist-to-sitting height ratio (WsHtR), and conicity index were all positively associated with the risk of CHD. With the exception of WHR, all other anthropometric indexes only predicted the risk of CHD among women ≤55 y of age at enrollment. The relative risks (RRs) between extreme tertiles of BMI were 9.0 (95% CI, 2.0–41.5; P for trend=0.002) for younger women vs 1.3 (0.6–3.0; P for trend=0.83) for older women. Similarly, the RRs for WC, WHtR, WsHtR, and conicity index were 6.1 (1.8–21.4) vs 1.9 (0.6–5.4), 9.4 (2.6–33.8) vs 1.2 (0.5–3.1), 15.2 (3.3–69.1) vs 1.0 (0.4–2.5), and 7.8 (2.2–28.0) vs 0.9 (0.4–2.3) for the young and elderly, respectively. In contrast, the RR for WHR was 3.2 (1.1–9.1) for the young and 2.9 (1.0–8.4) for the elderly.

CONCLUSIONS: WHR was positively associated with the risk of CHD in both younger and older women, while other anthropometrics, including BMI, were related to CHD risk primarily among younger women.

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References

  1. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000; 160: 898–904.

  2. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH . A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990; 322: 882–889.

    Article  CAS  Google Scholar 

  3. Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH . Weight, weight change, and coronary heart disease in women. JAMA 1995; 273: 461–465.

    Article  CAS  Google Scholar 

  4. Rimm EB, Stampfer MJ, Giovannucci E, Ascherio A, Spiegelman D, Colditz GA, Willett WC . Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol 1995; 141: 1117–1127.

    Article  CAS  Google Scholar 

  5. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE . Abdominal adiposity and coronary heart disease in women. JAMA 1998; 280: 1843–1848.

    Article  CAS  Google Scholar 

  6. Rexrode KM, Buring JE, Manson JE . Abdominal and total adiposity and risk of coronary heart disease in men. Int J Obes Relat Metab Disord 2001; 25: 1047–1056.

    Article  CAS  Google Scholar 

  7. Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ . Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994; 73: 460–468.

    Article  CAS  Google Scholar 

  8. Han TS, van Leer EM, Seidell JC, Lean ME . Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401–1405.

    Article  CAS  Google Scholar 

  9. Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G . A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. Int J Obes Relat Metab Disord 2001; 25: 652–661.

    Article  CAS  Google Scholar 

  10. Ho SC, Chen YM, Woo JL, Leung SS, Lam TH, Janus ED . Association between simple anthropometric indices and cardiovascular risk factors. Int J Obes Relat Metab Disord 2001; 25: 1689–1697.

    Article  CAS  Google Scholar 

  11. Hsieh SD, Yoshinaga H . Abdominal fat distribution and coronary heart disease risk factors in men-waist/height ratio as a simple and useful predictor. Int J Obes Relat Metab Disord 1995; 19: 585–589.

    CAS  Google Scholar 

  12. Hsieh SD, Yoshinaga H . Waist/height ratio as a simple and useful predictor of coronary heart disease risk factors in women. Intern Med 1995; 34: 1147–1152.

    Article  CAS  Google Scholar 

  13. Deurenberg P, Deurenberg-Yap M . Differences in body-composition assumptions across ethnic groups: practical consequences. Curr Opin Clin Nutr Metab Care 2001; 4: 377–383.

    Article  CAS  Google Scholar 

  14. Park YW, Allison DB, Heymsfield SB, Gallagher D . Larger amounts of visceral adipose tissue in Asian Americans. Obes Res 2001; 9: 381–387.

    Article  CAS  Google Scholar 

  15. Deurenberg P, Deurenberg-Yap M, Guricci S . Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 2002; 3: 141–146.

    Article  CAS  Google Scholar 

  16. Valdez R, Seidell JC, Ahn YI, Weiss KM . A new index of abdominal adiposity as an indicator of risk for cardiovascular disease. A cross-population study. Int J Obes Relat Metab Disord 1993; 17: 77–82.

    CAS  PubMed  Google Scholar 

  17. Rose GA, Blackburn H . Cardiovascular survey methods. WHO monograph series, No. 58 World Health Organization: Geneva, Switzerland; 1982.

    Google Scholar 

  18. Zhang X, Shu XO, Gao YT, Yang G, Li Q, Li H, Jin F, Zheng W . Soy food consumption is associated with lower risk of coronary heart disease in Chinese women. J Nutr 2003; 133: 2874–2878.

    Article  CAS  Google Scholar 

  19. Wen W, Gao YT, Shu XO, Yang G, Li HL, Jin F, Zheng W . Sociodemographic, behavioral, and reproductive factors associated with weight gain in Chinese women. Int J Obes Relat Metab Disord 2003; 27: 933–940.

    Article  CAS  Google Scholar 

  20. Folsom AR, Kushi LH, Anderson KE, Mink PJ, Olson JE, Hong CP, Sellers TA, Lazovich D, Prineas RJ . Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study. Arch Intern Med 2000; 160: 2117–2128.

    Article  CAS  Google Scholar 

  21. Molarius A, Seidell JC . Selection of anthropometric indicators for classification of abdominal fatness—a critical review. Int J Obes Relat Metab Disord 1998; 22: 719–727.

    Article  CAS  Google Scholar 

  22. Lean ME, Han TS, Morrison CE . Waist circumference as a measure for indicating need for weight management. BMJ 1995; 311: 158–161.

    Article  CAS  Google Scholar 

  23. Kim KS, Owen WL, Williams D, Adams-Campbell LL . A comparison between BMI and Conicity index on predicting coronary heart disease: the Framingham Heart Study. Ann Epidemiol 2000; 10: 424–431.

    Article  CAS  Google Scholar 

  24. Ashwell M, Cole TJ, Dixon AK . Ratio of waist circumference to height is strong predictor of intra-abdominal fat. BMJ 1996; 313: 559–560.

    Article  CAS  Google Scholar 

  25. Willett WC, Dietz WH, Colditz GA . Guidelines for healthy weight. N Engl J Med 1999; 341: 427–434.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Center for Health Services Research, Vanderbilt University, Nashville, TN, USA

    X Zhang, X O Shu, G Yang, C E Matthews & W Zheng

  2. Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China

    Y-T Gao, Q Li, H Li & F Jin

Authors
  1. X Zhang
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  2. X O Shu
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  3. Y-T Gao
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  4. G Yang
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  5. C E Matthews
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  6. Q Li
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  7. H Li
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  8. F Jin
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  9. W Zheng
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Correspondence to X O Shu.

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This work was supported by NIH grant R01CA70867.

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Zhang, X., Shu, X., Gao, YT. et al. Anthropometric predictors of coronary heart disease in Chinese women. Int J Obes 28, 734–740 (2004). https://doi.org/10.1038/sj.ijo.0802634

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