Association between waist-to-hip ratio and risk of myocardial infarction: a systematic evaluation and meta-analysis

Xiaojuan Zhang; Liu Yang; Cong Xiao; Jiacong Li; Tao Hu; Linfeng Li

doi:10.3389/fcvm.2024.1438817

Association between waist-to-hip ratio and risk of myocardial infarction: a systematic evaluation and meta-analysis

Front Cardiovasc Med. 2024 Dec 9:11:1438817. doi: 10.3389/fcvm.2024.1438817. eCollection 2024.

Authors

Xiaojuan Zhang^#¹, Liu Yang^#², Cong Xiao^#¹, Jiacong Li¹, Tao Hu², Linfeng Li²

Affiliations

¹ Medical College of Nanchang University, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China.
² Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.

^# Contributed equally.

Abstract

Background: Myocardial infarction(MI) is one of the most serious health threats. Despite the increasing number of clinical methods used to predict the onset of MI, the prediction of MI is still unsatisfactory and necessitates new methods.

Objective: To systematically review observational studies from the past two decades on the association between waist-to-hip ratio (WHR) and MI risk.

Methods: Original literature on the correlation between WHR and MI was searched in PubMed, Embase, Web of Science, Cochrane Library, Science Direct, CNKI, and Wanfang up to January 31, 2024. Two researchers independently screened, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS) and Revman5.3. Meta-analysis with Stata 16.0 calculated the combined Odd ratio (OR) for WHR and MI risk. Heterogeneity was assessed with the I ² statistic to select the appropriate effects model. Subgroup analysis, meta-regression, sensitivity analysis, and funnel plots tested for heterogeneity and publication bias.

Results: A total of 22 observational studies were included, involving 709,093 participants. The meta-analysis showed that an elevated WHR was significantly associated with an increased risk of MI, with a pooled odds ratio (OR) of 1.98 [95% Confidence interval (CI): 1.75-2.24] and high heterogeneity (I ² = 91.5%, P < 0.0001). Subgroup analysis revealed a stronger association between WHR and MI in women (OR: 1.99, 95% CI: 1.43-2.77) compared to men (OR: 1.74, 95% CI: 1.36-2.22). Regional analysis indicated that the association between WHR and MI risk was highest in Asian populations (OR: 2.93 95% CI: 1.61-5.33), followed by American (OR: 1.73, 95% CI: 1.45-2.08) and European populations (OR: 2.19, 95% CI: 1.49-3.22). Sensitivity analysis demonstrated that the results remained stable after excluding one study.

Conclusion: In the general adult population, a higher WHR is a potentially significant association for MI and has predictive value for MI.

Keywords: central obesity; incidence rate; meta-analysis; myocardial infarction; waist-to-hip ratio.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Integrative Chinese and Western Medicine Expert Consensus Project of Angina Pectoris after Coronary revascularization, a pilot project of clinical cooperation of major difficult diseases, No. 2020050.