• Karolyn Boyd

Predictor of risk of incidence of cardiovascular disease events

Risks are increased with diabetes depending on the pattern of fat distribution in the body (Srikanthan et al., 2009). In the human body, there are two major types of fat: 1 - visceral, which maintains the free fatty acid levels in the blood, and facilitates in the regulation of blood insulin and 2 - subcutaneous fat which may be found directly under the skin and contains larger blood vessels and nerves and acts as padding and as an energy reserve, and also provides minor thermoregulation via insulation. Fat may also be found in smaller amounts in the heart, pancreas, liver and within muscle (intramuscular fat) which is used for fuel during exercise. Fat is considered an endocrine organ that secretes hormones as well as specialized proteins known as cytokines, which regulate responses to infection, immune reactions, inflammation and trauma (Dinarello, 2000). Resistance of the body to respond to insulin secreted by the pancreas, which is common in metabolic conditions, is often due to increased inflammatory processes in the body caused by increased amount of fat.

In my practice, I use bioelectrical impedance analysis to determine body composition, Body Mass Index, waist circumference, as well as waist to hip ratio to detect cardiovascular and metabolic risks. Waist to hip ratio can easily be measured in the privacy of your own home. For the waist-to-hip ratio, the waist is measured at the narrowest part of the waist, between the lowest rib and the iliac crest (the top of the hip bone in the pelvis), and the hip circumference is taken at the widest area of the hips at the greatest protuberance of the buttocks. Then, you would simply divide the waist measurement by the hip measurement. The World Health Organization defines the ratios of >0.90 in men and >0.85 in women as one of the decisive benchmarks for metabolic syndrome. As you may see by observing the table above, this level is at the lower extremity of the unacceptable values. You may now see where you stand.

Obviously, waist-to-hip ratio is a general measure of central adiposity that appears to predict cardiovascular and diabetes risk, but also indicates the location of the fat deposits in the body. Much research denotes that the waist-to-hip ratio is the superior health risk-categorizing indicator (Welborn et al., 2007; Srikanthan et al., 2009). You now have a way of measuring the severity of your condition at home.

Dinarello, C.A. (2000). Proinflammatory cytokines. Chest. 8(2): 503 - 508.

Skrikanthan, P., Seeman, T.E., and Karlamangla, A.S. (2009). Waist-hip-ratio as a predictor of all-cause mortality in high-functioning older adults. Annals of Epidemiology, 19, 724 - 731.

Welborn, T.A. and Dhaliwal, S.S. (2007). Preferred clinical measures of central obesity for predicting mortality. European Journal of Clinical Nutrition, 61, 1373 - 1379.

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