CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 8, September 2012
442
AFRICA
Association of waist circumference, body mass index
and conicity index with cardiovascular risk factors in
postmenopausal women
FARZAD SHIDFAR, FATEMEH ALBORZI, MARYAM SALEHI, MARZIEH NOJOMI
Abstract
In menopause, changes in body fat distribution lead to
increasing risk of cardiovascular disease and metabolic
disorders. The aim of this study was to assess the association
of adiposity using the conicity index (CI), body mass index
(
BMI) and waist circumference (WC) with cardiovascular
risk factors (hypertension, diabetes and dyslipidaemia). The
sample of this cross-sectional study was collected from June
to October 2010 and 165 consecutive menopausal women
who had attended the Health and Treatment Centre and
Endocrine Research Centre of Firoozgar Hospital in Tehran,
Iran were assessed. Age, weight, height, WC, waist–hip ratio
(
WHR), CI and fat mass were measured. Systolic and dias-
tolic blood pressure (SBP and DBP), fasting blood glucose,
insulin, low-density lipoprotein cholesterol (LDL-C), high-
density lipoprotein cholesterol (HDL-C) and total cholesterol
(
TC) levels were also determined.All statistical analyses were
performed by SPSS version 17 (SPSS Inc, Chicago, IL, USA).
Results showed that BMI was positively and significantly
associated with SBP (
r
=
0.21;
p
=
0.009).
WC was positively
and significantly correlated with SBP (
r
=
0.26;
p
=
0.02)
and
DBP (
r
=
0.16;
p
=
0.05).
WHR was also significantly and
positively associated with SBP (
r
=
0.29;
p
=
0.001).
Age and
WC were associated with CI quartiles at the 0.05 signifi-
cance level. The correlation of CI quartiles with SBP and
weight were at the 0.01 significance level.
We showed a significant association of WC with SBP
and DBP, and that BMI could be an important determin-
ing factor of SBP. For assessing the association between CI
and cardiovascular risk factors, future studies with larger
sample sizes are recommended.
Keywords:
body mass index, cardiovascular risk factors, conic-
ity index, waist circumference
Submitted 23/2/11, accepted 3/5/12
Cardiovasc J Afr
2012;
23
: 442–445
DOI: 10.5830/CVJA-2012-038
Epidemiological studies have found a progressive increase in
the prevalence of cardiovascular risk factors (dyslipidaemia,
elevated blood pressure, disturbances in glycaemic control)
with increasing body fatness.
1-3
In recent decades, many
prospective and cross-sectional studies using anthropometric
measures have been undertaken in order to understand the
relationship between obesity and cardiovascular risk factors.
Various obesity measurements such as body mass index (BMI),
waist circumference (WC) and waist-to-hip ratio (WHR) were
investigated. However, the best obesity measure to use as a
predictor of cardiovascular risk factors remains elusive.
4-5
BMI is the most commonly used and simple measure of body
size, especially for estimating the frequency of obesity in large
epidemiological studies.
6
This index cannot however be used
for the evaluation of body fat distribution and abdominal fat
mass. It has been shown that intra-abdominal fat has a stronger
relationship with risk of obesity-related morbidity than with
overall adiposity.
7
Therefore WHR and WC measurements can
be used as valid alternatives to BMI for the evaluation of intra-
abdominal mass and total fat.
8
A study by Huang and co-workers showed that WHR and
WC measurements were strongly associated with incidence
of coronary heart disease, independent of BMI.
9
However the
validity of WHR measurements has been questioned as an
indicator of abdominal adipose tissue distribution.
10
Another index of abdominal adiposity is the conicity index
(
CI). This has a theoretical range, includes a built-in adjustment
of waist circumferences for height and weight, and does not
require the hip circumference to assess fat distribution.
11,12
In menopause, changes in body fat distribution lead to
increasing risk of cardiovascular and metabolic diseases.
Increase in abdominal obesity together with acceleration of
the breakdown of lean body mass means there is no significant
change in the body weight of postmenopausal women.
7,8
Since the prediction of cardiovascular disease by the presence
of risk factors is of such importance, anthropometric indices
are seen as useful indicators to achieve this. The aim of this
study was to assess the association of adiposity using the
conicity index, BMI and WC, with cardiovascular risk factors
(
hypertension, diabetes and dyslipidaemia).
Methods
This cross-sectional study was carried out from June to October
2010.
Using the non-probability convenience method, 165
consecutive menopausal women who had attended the Health and
Treatment Centre and Endocrine Research Centre of Firoozgar
Hospital in Tehran, Iran, were invited to participate. Subjects
were informed on the objectives of the study. The study was
approved by the ethics committee of the Medical School of Iran
University of Medical Sciences.
Inclusion criteria for the study were: being naturally
menopausal for at least one year, non-smokers, and having a BMI
Department of Nutrition, School of Health, Tehran University
of Medical Sciences, Tehran, Iran
FARZAD SHIDFAR, PhD
Department of Community Medicine, Tehran University of
Medical Sciences, Tehran, Iran
FATEMEH ALBORZI, BSc
MARYAM SALEHI, MD, MPH
MARZIEH NOJOMI, MD, MPH,
