A useful index highly correlated with coronary risk factors for community based obesity screening

Obesity is associated with an increased risk for all cause mortality especially coronary heart disease (CHD). An obesity index highly correlated with coronary risk factors (CRF) has not been well studied, especially in Japan. This study compared obesity indices: body mass index (BMI), percentage of body fat (%Fat), waist to hip ratio (WHR), waist to stature ratio (WSR) and subscapular to triceps subcutaneous fat ratio (Sub/Tri) with CRF, including systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and fasting blood sugar (FBS). The subjects were 4,551 Japanese males and females, aged 15-84 years who had a community based health examination between 1991-1997, and were initially free from CHD and other major chronic diseases. The strongest associations were revealed between WSR and waist circumference with all CRF in males and females, and also WHR with TC and FBS in males. After adjustment for age, the risk ratio of CRF rose significantly with increasing BMI, %Fat, WHR and WSR. Among these, WSR and waist circumference yielded the sharpest risk ratio gradient, although FBS was not significantly correlated. Moreover, for those who have at least one high value in a CRF, compared to the lowest category, the highest category of WSR and waist circumference had the highest age-adjusted risk ratio. The high correlation of WSR and waist circumference with these CRF suggests that WSR and waist circumference are potentially useful in community based obesity screening.