Tag: abdominal fat

Categories : Cardiovascular Disease Metabolic DisordersTags :

Waist-to-Height Ratio Better than BMI at Predicting Cardiovascular Risk

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Photo by Andres Ayrton on Pexels

The ratio of a person’s waist measurement compared to their height is more reliable than body mass index (BMI) at predicting heart disease risk, according to new research from UPMC and University of Pittsburgh physician-scientists. 

This finding, published out now in The Lancet Regional Health—Americas, could reshape how clinicians and the public assess cardiovascular risk, especially for people who don’t meet the classic definition of obesity. 

The team analysed data from 2721 adults who had participated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The individuals had no cardiovascular disease at baseline and were followed for more than five years. 

“Higher BMI, waist circumference and waist-to-height ratio at baseline were all associated with higher risk of developing future cardiovascular disease – until we adjusted for other classic risk factors, such as age, sex, smoking, exercise, diabetes, hypertension and cholesterol,” said lead author Thiago Bosco Mendes, clinical instructor of medicine at Pitt and obesity medicine fellow at UPMC. “When we did that, only waist-to-height ratio held as a predictor.” 

Much of that predictive power is concentrated among individuals with a BMI under 30, which is below the classic threshold for obesity, who may not realise they are at risk for cardiovascular disease.  

BMI doesn’t account for fat distribution or distinguish between harmful, visceral fat and protective, subcutaneous fat. By contrast, waist-to-height ratio (WHtR), calculated by dividing waist circumference by height, directly reflects central obesity, which is more closely linked to heart disease. That means that people with a BMI lower than 30, but a WHtR over 0.5, may be at higher risk of future coronary artery calcification, a key marker of cardiovascular disease, even in the absence of other risk factors. 

“Using waist-to-height ratio as a cardiovascular screening tool could lead to earlier identification and intervention for at-risk patients who might otherwise be missed,” said senior author Marcio Bittencourt, associate professor of medicine at Pitt and cardiologist at UPMC. “It’s a simple and powerful way to spot heart disease risk early, even if a patient’s weight, cholesterol and blood pressure all seem normal.” 

Source: University of Pittsburgh School of Medicine

Categories : Dermatology Metabolic DisordersTags :

Abdominal Fat More Linked to Psoriasis Risk than Total Body Fat

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Findings in the Journal of Investigative Dermatology reinforce the role of weight management in psoriasis care

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Researchers have found that central body fat, especially around the abdomen, is more strongly linked to psoriasis risk than total body fat, particularly in women. This link between central fat and psoriasis remained consistent regardless of genetic predisposition, indicating that abdominal fat is an independent risk factor. The study in the Journal of Investigative Dermatology, published by Elsevier, provides insights that could help improve early risk prediction and guide personalised prevention strategies.

While it is well established that increasing levels of body fat raise the risk of developing psoriasis, the impact of specific fat distribution and genetics remains unclear.

Researchers of the current study analysed data from over 330 000 participants with White British ancestry in the UK Biobank, including more than 9000 people with psoriasis. They examined 25 different measures of body fat using both traditional methods and advanced imaging techniques, assessing how each was associated with psoriasis.

Lead investigator Ravi Ramessur, MD, St John’s Institute of Dermatology, King’s College London, explains, “Our research shows that where fat is stored in the body matters when it comes to psoriasis risk. Central fat – especially around the waist – seems to play a key role. This has important implications for how we identify individuals who may be more likely to develop psoriasis or experience more severe disease, and how we approach prevention and treatment strategies.”

Senior author Catherine H. Smith, MD, also at King’s College London, adds, “As rates of obesity continue to rise globally, understanding how different patterns of body fat influence chronic inflammatory conditions such as psoriasis is important. Our findings suggest that central body fat contributes to psoriasis risk irrespective of genetic predisposition and reinforces the importance of measuring waist circumference and pro-active healthy weight strategies in psoriasis care.”

Because this study only included individuals of White British ancestry from the UK Biobank, the generalisability of these findings to more diverse populations may be limited. Future studies incorporating datasets with dermatologist-confirmed diagnoses and broader ethnic representation will be important to further validate these associations and refine risk stratification approaches.

Dr Ramessur notes, “We were surprised by how consistently strong the association was across different central fat measures and how much stronger the effect was in women. The observed links between central body fat and psoriasis suggest that there may be underlying biological mechanisms contributing to the disease that are not yet fully understood and which warrant further investigation.”

In an accompanying editorial Joel M. Gelfand, MD, MSCE, FAAD, at the University of Pennsylvania Perelman School of Medicine, points to the potential of incretin therapy for psoriatic disease. Incretins are gut-derived hormones, principally glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), that regulate glucose, digestion, and appetite, and are approved for treatment of diabetes, obesity, and obesity-associated obstructive sleep apnoea.

Dr Gelfand comments, “The strong relationship between psoriasis and obesity and the emerging promise of glucagon-like peptide-1 receptor agonists (GLP1RA) for reducing psoriasis morbidity is a call to action for large scale clinical trials of GLP1RA monotherapy for treatment of psoriasis. Our current paradigm of just focusing on the skin and joint manifestations when treating psoriasis is outdated in the context of our evolving understanding of the tight relationship of psoriasis, obesity, and cardiometabolic disease.“

Source: Elsevier