Proposal for a new cut-off point for waist-to-hip ratio in women with severe obesity: A cross-sectional study

Background: Obesity is a chronic disease that increases the risk of cardiovascular diseases (CVD), including systemic arterial hypertension (SAH), underestimated in this population. The high mortality related to CVD reveals the need for early screening. One of the training tools is the waist-to-hip ratio (WHR). However, few studies evaluate its relationship with metabolic changes in severe obesity, making necessary a new cut-off point.

Method: Cross-sectional study with 75 Brazilian women with severe obesity (mean age: 37,6 years; weight of 122 kg and body mass index (BMI) of 47,8 kg/m²). Height, weight, neck circumference (NC), hip (HC), waist (WC) and waist-to-hip ratio (WHR) were obtained. Blood samples were collected for lipid/glucose profile. The Receiver Operating Characteristic (ROC) was explored to define cut-off points for WHR based on SAH. Women were compared using the t-Student/Mann Whitney test. Pearson/Spearman correlations were performed, and the significance level was set at 5%.

Results: The ROC curve indicated that WHR ≥0.92 best predicted SAH. The group with WHR ≥0.92 had higher Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p = 0.037), insulin (p = 0.037), NC (p = 0.004), and Atherogenic Index of Plasma (AIP) (p = 0.038). WHR correlated with NC (p = 0.002; r = 0.358), glucose (p = 0.026; r = 0.270); insulin (p = 0.05; r = 0.238); HOMA-IR (p = 0.01; r = 0.3238), triglycerides (p = 0.006; r = 329) and AIP (p = 0.02; r = 0.370).

Conclusions: A new cut-off point for WHR related to SAH in severe obesity is suggested.