Abdominal Obesity and Coronary Heart Disease in Thai Men

OBJECTIVE: To determine the association of four simple anthropometric indices with coronary heart disease (CHD) in Thai men, and to determine the optimal cut-off points for each index in the prediction of CHD. RESEARCH METHODS AND PROCEDURES: This is a cohort study with 17 years of follow-up. A total of 2536 male employees from the Electricity Generating Authority of Thailand 35 to 59 years of age at baseline were included in the study. Height, weight, waist circumference, and hip circumference were measured to generate BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Cox regression models were used to estimate hazard ratios by thirds of each index. Receiver operating characteristic curves were used to assess discrimination of CHD. RESULTS: WHtR was most strongly associated with CHD events in Thai men. The age-adjusted hazard ratio for those in the highest, compared with the lowest, third was 2.89 (1.37, 6.11). Although WHtR had the largest area under the receiver operating characteristic curve (AUC) with the optimal cut-off estimated to be 0.51 (sensitivity, 55%; specificity, 61%), no statistically significant difference (p>0.10) was found between the AUC for WHtR and that for the other three indices. CONCLUSION: WHtR is, marginally, the best of the four indices considered to predict CHD events in Thai men.