Cardiometabolic risk identification improved with combined indices

Using a composite index method to assess cardiometabolic risk could improve classification among middle-aged patients, according to findings presented at the European Congress on Obesity in Sofia, Bulgaria.

Considering BMI and waist-to-height ratio together when evaluating cardiometabolic risk increased efficiency and precision in identifying patients at increased odds in a cross-sectional study of 2,047 Irish men and women.

“Just as we don’t usually use one test alone for diagnosing a chronic condition such as type 2 diabetes, nor do we have to rely on one adiposity measurement to define obesity in order to detect people at high-risk of cardiometabolic disease,”Seán Millar, PhD, of the University College Cork, Ireland, said in a press release.

Millar and colleagues assessed metabolic and anthropometric profiles of participants aged 50 to 69 years, representing a random sampling from phase 2 of the single-center Cork and Kerry Diabetes and Heart Disease Study.

The researchers compared lipid, blood pressure, glycemic and inflammatory biomarker levels between BMI and waist-to-height ratio tertiles, both divided into three groups — obese, overweight and normal weight. Cardiometabolic feature and biomarker risk factor association were determined for the groupings.

Clear and significant metabolic variable differences were observed across patients who were overweight or obese when BMI and waist-to-height ratio percentiles were combined. Patients classified as overweight or obese by both indices had noticeably increased odds ratios for cardiometabolic risk factors compared with categorized by either BMI or waist-to-height ratio individually.

For patients with obesity in the highest BMI and waist-to-height ratio percentile, the prevalence was 81% for high blood pressure, 55% for insulin resistance, 34% for cardiometabolic feature clustering and 17% for prediabetes.

“This could enable a more effective use of intervention or therapeutic strategies,” Millar said, “and may be particularly helpful in resource-poor settings or in countries without universal primary health care.”

For more information:

Millar S. Presented at: 21st European Congress on Obesity; May 28-31, 2014; Sofia, Bulgaria.

Disclosure: The study was supported by a research grant from the Irish Health Research Board.