Relationships between waist and hip circumference and 10-year cardiovascular disease risk: findings from the baseline data of a Hong Kong women cohort

Introduction: Limited studies have investigated the threshold effects of the associations between anthropometric parameters and the risk of cardiovascular disease (CVD) in Asian female population. The purpose of this study was to
examine the associations of 10-year CVD risk with waist circumference (WC), hip circumference (HC) and waist-hip-ratio (WHR) in a sample of Hong Kong Chinese women and to explore the possible threshold effects.
Materials and methods: Data were extracted from a prospective cohort study that contained 4,222 Hong Kong women aged from 30 to 74 years and free of CVD at the baseline assessment during 2020 and 2021. In total 3,809 (90.22%)
women who took physical examinations (blood pressure, height, weight, WC and HC) and lipid test (cholesterol, high density lipoprotein) were included in the analysis. The demographics, disease status, lifestyle factors and other covariates were collected by questionnaires through face-to-face interview. The 10-year CVD risk was calculated by the laboratory-based Framingham 10-year risk score (FRS). Multiple linear regression model was adopted to exam the relationships between anthropometric variables and 10-year CVD risk. Two-piecewise linear regression model was further used to explore the threshold effects, with the threshold value automatically calculated by recursive algorithm.
Results: The average age of the participants was 55.8±8.8 years. The mean WC and HC was 78.9±9.4 cm and 94.7±6.7 cm, respectively; 43.0% of the participants had central obesity (WC≥80 cm). The median of FRS was 0.05 (interquartile range: 0.03 to 0.08), 14.9% of the participants had a high level of CVD risk (FRS ≥ 10%). After adjustment of BMI, education level, occupation, physical activity and drinking, 1-cm increase in WC was associated with 0.13 (95% CI: 0.10 to 0.16) units increase in FRS; while 1-cm increase in HC predicted -0.23 (95% CI: -0.27 to -0.20) units changes of FRS. The WHR was positively associated with FRS (β=19.50, 95% CI: 17.27 to 21.72). Threshold effects existed in all three anthropometric parameters. The regression coefficient was 13.11 (95% CI: 7.93 to 18.28) for WHRConclusion: Larger WC but smaller HC predicted the higher 10-year CVD risk in Hong Kong Chinese women. When the women's WC and WHR excessed a threshold value, the 10-year CVD risk was aggravated.