1 Secretary of Education of São Paulo, Brasil; 2 Fluminense Federal University, Brasil; 3 University of São Paulo, Brasil.
Introduction: Overall and central obesity indicators, such as body mass index, waist circumference and waist-to-height ratio, have been used as practical and non-invasive methods for obesity diagnosis and metabolic cardiovascular risk evaluation. However, it remains unclear whether overall and central obesity indicators relate similarly to multiple metabolic cardiovascular disease risk factors. Objective: To explore and model the interrelationships among overall and central obesity indicators and metabolic cardiovascular disease risk factors. Method: A total of 482 subjects, both sexes, aged ≥20 years were evaluated in a cross-sectional population-based study performed in São Paulo, Brazil, in 2008. Structural equation models were used to model the interrelationships between overall (body mass index) and central obesity indicators (waist circumference; waistto- height ratio), inflammation (high-sensitivity C-reactive protein), blood pressure (systolic and diastolic blood pressure; mean arterial pressure) and lipid profile (total cholesterol/HDL-cholesterol; triacylglycerol/ HDL-cholesterol). Results: Body mass index was positively associated with high-sensitivity C-reactive protein (β=0.207) and blood pressure (β=0.160), but not with lipid profile (β=0.024). Conversely, waist circumference had no effect on high-sensitivity C-reactive protein (β=0.060) and blood pressure (β=0.040), but had positive effects on lipid profile (β=0.362). Replacing waist circumference by waist-to-height ratio, the former had significant positive effects on lipid profile (β=0.289), high-sensitivity C-reactive protein (β=0.166) and blood pressure (β1=0.228). Body mass index, however, had no effects on blood pressure (β=0.09) and lipid profile (β=0.105), but had positive effect on high-sensitivity C-reactive protein (β=0.124). Conclusion: Overall and central obesity indicators are different predictors of metabolic disease risk factors. Waist-toheight ratio outperformed body mass index and waist circumference as a predictor of metabolic risk.