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Wrist circumference is a practical tool for assessment of metabolic risk in overweight-obese subjects but not as marker of advanced atherosclerosis

Body circumferences have been proposed as potential anthropometric measures for the assessment of cardiometabolic risk as they are independently associated with insulin resistance and diabetes.

The aim of a study was to validate neck and wrist circumference and waist-to-hip ratio as practical markers of metabolic dysfunction and atherosclerosis; 120 subjects who underwent coronary angiography and carotid Doppler ultrasound were enrolled in this cross-sectional study.
Exclusion criteria were history of diabetes, acute myocardial infarction, body mass index ( BMI ) less than 18.5 or greater than or equal to 45.0 kg/m2.

Metabolic dysfunction was ascertained by the calculation of visceral adiposity index ( VAI ) and by diagnosis of metabolic syndrome. 
Advanced atherosclerotic disease was defined as greater than or equal to 70% coronary lumen and/or greater than or equal to 50% carotid lumen stenosis.

No association between body circumferences and visceral adiposity index or metabolic syndrome ;was found in subjects with BMI less than 25 kg/m2.

VAI was significantly related to waist-to-hip ratio ( R2 = 0.09, p = 0.008 ), neck ( R2 = 0.09, p = 0.007 ), and wrist circumferences ( R2 = 0.05, p = 0.041 ) in subjects with BMI greater than or equal to 25 kg/m2.

In overweight subjects, higher gender-specific tertiles of wrist circumference were independently associated with an increased risk of metabolic syndrome ( odds ratio 2.57, 95% confidence interval 1.11 to 5.96, p = 0.028 ).

Visceral adiposity index was independently associated with carotid intima-media thickness: beta = 0.104, R2 = 0.118, p = 0.003.

Carotid intima-media thickness and metabolic syndrome, but not body circumferences, were associated with advanced atherosclerosis.

In conclusion, these data have indicated that anthropometric measurements, in particular wrist circumference, can be used as practical tools for assessment of metabolic risk in overweight-obese subjects but not as markers of advanced atherosclerosis. ( Xagena )

Maddaloni E et al, Am J Cardiol 2016; Epub ahead of print