Measuring Abdominal Obesity: Effects of Height on Distribution of Cardiometabolic Risk Factors Risk Using Waist Circumference and Waist-to-Height Ratio

  1. Hans-Ulrich Wittchen, PHD3
  1. 1Medizinische Klinik-Innenstadt, Ludwig-Maximilians University, Munich, Germany;
  2. 2Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Greifswald, Germany;
  3. 3Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany;
  4. 4Cardiologic Practice, Munich, Germany;
  5. 5Max Planck Institute of Psychiatry, Munich, Germany.
  1. Corresponding author: Harald J. Schneider, harald.schneider{at}

Accumulating evidence suggests that measures of abdominal obesity outperform BMI in predicting diabetes and cardiovascular risk (13). However, it is debated which measure of obesity should be used. Currently, waist circumference (WC) is most commonly used and codefines the metabolic syndrome (4).

Unlike waist-to-height ratio (WHtR), WC does not take differences in height into account. We hypothesized that short subjects with a WC at a specified cutoff-point will have more abdominal fat and associated cardiovascular risk factors than tall subjects with a WC at the same cutoff-point and that this will not be the case if WHtR is used instead of WC. To test this hypothesis, we compared the distribution of cardiovascular risk factors according to height above and below commonly used cutoffs of WC and WHtR in a cross-sectional study.

We studied 6,971 subjects (mean age 57.6 ± …

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