Waist circumference may be a predictor of cardiovascular disease or stroke in Japanese women, according to a study published in the January 7 online Stroke.
Yoko Furukawa, MS, a student at the Graduate School of Humanities and Sciences at Nara Women’s University in Japan, and colleagues assessed 5,474 Japanese persons (ages 30 to 79) without cardiovascular disease at baseline. All participants were followed up for a mean of 11.7 years through December 2005. Waist circumference was measured at the umbilical level of participants in the standing position to the nearest 1 cm. Cox proportional hazard ratios for cardiovascular disease according to the quartiles of waist circumference were calculated after adjustment for age, smoking, and drinking status.
In the follow-up period, 207 strokes and 133 myocardial infarctions were documented. “In women, compared with the lowest quartile (waist circumference
“The reasons for the sex differences are unclear but may involve differences in lifestyle background, severity of obesity, or prevalence of risk factors in nonobese subjects,” Ms. Furukawa and coauthors commented.
“After further adjustment of hypertension, diabetes, and hypercholesterolemia, all of the mentioned relationships were not statistically significant,” Ms. Furukawa and her team noted. “No associations of BMI with cardiovascular disease or strokes were observed…. Therefore, waist circumference might likely be on the causal pathway leading to the more proximal risk factors for cardiovascular disease and contributes to risk through those factors.”
Although abdominal obesity without other cardiovascular risk factors does not predict the risk of cardiovascular disease, increasing abdominal disease may lead to those factors.
Ms. Furukawa and coauthors noted several limitations to their study, including regression dilution bias, small sample size for subgroup analysis, lifestyle background, and measurement of waist circumference at the umbilical level rather than at the midpoint between the lower rib and the iliac crest.
“However, the correlation coefficients between values measured by using both methods for measurement of waist circumference were reported to be high,” the researchers stated.
“In conclusion, our findings suggested that waist circumference was associated with an increased risk of cardiovascular disease and stroke in Japanese women,” Ms. Furukawa and coauthors wrote. “From a public health perspective, measurement of waist circumference could be a useful tool for use in preliminary screening for high risk of cardiovascular disease.”
—Laura Sassano