Association Between Waist-to-Height Ratio and Endothelial Dysfunction in Patients With Morbidity　― A Report From the FMD-J Study ―

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  • Tokushige Akihiro
    Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus
  • Ueda Shinichiro
    Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus
  • Tomiyama Hirofumi
    Department of Cardiology, Tokyo Medical University
  • Ohishi Mituru
    Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
  • Kohro Takahide
    Department of Clinical Informatics, Jichi Medical University School of Medicine
  • Higashi Yukihito
    Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical Science
  • Takase Bonpei
    Division of Biomedical Engineering, National Defense Medical College Research Institute
  • Suzuki Toru
    Cardiovascular Medicine, University of Leicester
  • Ishizu Tomoko
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Yamazaki Tsutomu
    Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo
  • Furumoto Tomoo
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
  • Kario Kazuomi
    Division of Cardiovascular Medicine, Jichi Medical University School of Medicine
  • Inoue Teruo
    Department of Cardiovascular Medicine, Dokkyo Medical University
  • Koba Shinji
    Department of Medicine, Division of Cardiology, Showa University School of Medicine
  • Takemoto Yasuhiko
    Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine
  • Hano Takuzo
    Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University
  • Sata Masataka
    Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Ishibashi Yutaka
    Department of General Medicine, Shimane University Faculty of Medicine
  • Node Koichi
    Department of Cardiovascular and Renal Medicine, Saga University
  • Maemura Koji
    Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Ohya Yusuke
    The Third Department of Internal Medicine, University of the Ryukyus
  • Furukawa Taiji
    Department of Internal Medicine, Teikyo University School of Medicine
  • Ito Hiroshi
    Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Yamashina Akira
    Department of Cardiology, Tokyo Medical University

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Abstract

<p>Background:Waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI) are known as easy anthropometric markers of abnormal obesity and screening tools for predicting cardiovascular outcomes, but which indices are best is unclear. We therefore investigated the superiority and association between each index and low flow-mediated dilatation (FMD) as a surrogate marker for cardiovascular outcomes in patients with morbidity in a large Japanese prospective cohort.</p><p>Methods and Results:A total of 1,645 Japanese patients who had coronary artery disease and hypertension or diabetes mellitus were enrolled, and 1,087 of them were analyzed. The high-WHtR group (≥0.5) showed greater morbidity and increased inflammation in association with atherosclerosis compared with the low-WHtR group. High WHtR and advanced age were identified as predictors of low FMD (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.02–1.88, P=0.037 and OR 1.55, 95% CI 1.19–2.01, P=0.001, respectively). However, WC was not associated with that risk in either sex (male: OR 1.37, 95% CI 0.97–1.93, P=0.076; female: OR 1.08, 95% CI 0.68–1.73, P=0.74), and no association was evident between high BMI and low FMD (OR 0.92, 95% CI 0.71–1.19, P=0.54).</p><p>Conclusions:WHtR offers a superior predictor of decreased FMD than other anthropometric indices, and progression of arteriosclerosis might be detected more sensitively. Further study is needed to investigate the relationship between cardiovascular mortality and WHtR.</p>

Journal

  • Circulation Journal

    Circulation Journal 81 (12), 1911-1918, 2017

    The Japanese Circulation Society

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