Waist Circumference Below Metabolic Syndrome Harmonizing Criteria is Associated With Increased Cardiovascular Risk

Aim: to test the hypothesis that waist circumference (WC) just below Joint Interim Statement ([JIS], 2009) abdominal obesity thresholds can be associated with worse risk factors profile than smaller WC. Methods. In a study of risk factors in families of patients with "premature" coronary heart disease (CHD) we examined 229 persons without CHD with body mass index (BMI) >= 18.5 kg/m(2) and WC <94 cm (men) or <80 cm (women) (67 spouses [28-62 years] and 162 children [16-37 years]) of probands. Risk factors studied included smoking, BMI, WC, BP, total and high density lipoprotein cholesterol (HDL-C), triglycerides (TG), basal serum glucose, diabetes and metabolic syndrome (MS JIS criteria, 2009). High BP was defined as prehypertension (PreHT) or hypertension (HT) and named PreHT/HT. In persons aged 16-17 years we used criteria 4-th report of National High BP Education Program Working Group on High BP in Children and Adolescents, in persons >= 18 years - 7-th Joint National Committee Report (USA). TG >= 1.7 mmol/l, serum basal glucose >= 5.6 mmol/l were defined high, HDL-C <1.0 mmol/l (men), <1.3 mmol/l (women) - low. Framingham risk score of cardiovascular disease (CVD) was calculated for persons aged >= 30 years. Factors associated with various ranges of WC were selected by logistical regression 'univariate' analysis. Odds ratios were compared in 2 groups of WC distribution: top (>= 83 cm men, >= 73 cm women - intermediate [1] WC) vs 2 lower (<83 cm men; <73 cm women) tertiles. Analysis was carried out in 2 age groups according to median age: 16-26 years (n=115, 23.5% with IWC) and 27-62 years (n=114, 50.0 % with IWC). Results. Persons aged 16-26 years with IWC had significantly higher risk to have high TG, low HDL-C and PreHT/HT than those with smaller WC: odds ratios 7.53 (95% confidence interval [CI] 1.69-33.6; p=0.008), 3.56 (95% CI 1.35-9.36; p=0.010) and 2.22 (95% CI 1.13-4.36; p=0.020), respectively. No significant relationship was found between IWC and registered risk factors in age group 27-62 years. In persons aged 30-62 years (n=90, 51.1% with IWC) IWC was related to presence of >= 5% Framingham risk score: OR vs smaller WC 2.59 (95% CI 1.01-6.67; p=0.048). Conclusion. Among younger consorts and adult children of patients with "premature". CHD persons with WC - 83 <94 cm (men), 73 - <80 cm (women) had worse risk factors profile compared with persons with smaller WC.