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Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis
SYSTEMATIC REVIEW — Volume 17 — October 22, 2020
PEER REVIEWED
We identified 2,457 articles for possible analysis through database searching (PubMed, n = 771; Web of Science, n = 575; Cochrane, n = 439; Scopus, n = 478; Proquest, n = 194) and identified 23 from other sources (Google Scholar, n = 9; Magiran, n = 3; SID, n = 1; reference checking, n = 10). We removed duplicate publications (n = 892) and were left with 1,588 articles. We reviewed the titles and abstracts of those 1,588 articles, and excluded 1,356 that were found not to be relevant. We then had 232 full-text articles for possible inclusion. Of those, we excluded 194 articles for the following reasons: 146 had no relevant outcome data; 9 were studies on a specific subpopulation; 10 were not available in English; 5 were systematic reviews and/or meta-analyses; 19 did not report cut-offs, AUC, or sensitivity and specificity; 2 were conference abstracts; and 3 did not study an adult population. After screening and exclusion, we had 38 articles for qualitative and quantitative syntheses.
Figure 1.
PRISMA flowchart of the study selection process. Abbreviations: AUC, area under the receiver operating characteristic curve; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2.
Random-effects pooled area under the ROC curve (AUC) and test of heterogeneity for body mass index with cardiovascular disease or cardiometabolic disease for men and women. The dashed lines indicate the null model. Weighted percentages determined by using random effects analysis. Abbreviation: ROC, receiver operating characteristic.
| Study, Year | AUC (95% Confidence Interval) | Weighted % |
|---|---|---|
| Men | ||
| Al-Lawati, 2008 | 0.60 (0.56-0.64) | 7.54 |
| Ptanga, 2005 | 0.64 (0.57-0.71) | 5.84 |
| Zeng, 2014 | 0.71 (0.71-0.71) | 8.48 |
| Samsen, 2012 | 0.67 (0.66-0.68) | 8.38 |
| Haun, 2009 | 0.64 (0.57-0.71) | 5.84 |
| Kim, 2016 | 0.54 (0.53-0.55) | 8.42 |
| Lin, 2002 | 0.69 (0.68-0.70) | 8.46 |
| Wakabayashi, 2012 | 0.71 (0.70-0.72) | 8.46 |
| Hadaegh, 2009 | 0.57 (0.53-0.61) | 7.35 |
| Zabetian, 2009 | 0.57 (0.53-0.61) | 7.35 |
| Ho, 2003 | 0.76 (0.73-0.79) | 7.84 |
| Mirmiran, 2004 | 0.71 (0.68-0.74) | 7.84 |
| Katulanda, 2011 | 0.71 (0.69-0.73) | 8.19 |
| Overall (I2= 99.1%,P< .001) | 0.66 (0.63-0.69) | 100.0 |
| Women | ||
| Al-Lawati, 2008 | 0.64 (0.60-0.67) | 5.79 |
| Foucan, 2002 | 0.71 (0.69-0.73) | 6.18 |
| Wildman, 2004 | 0.51 (0.48-0.54) | 6.08 |
| Ptanga, 2005 | 0.59 (0.53-0.65) | 4.98 |
| Pua, 2004 | 0.69 (0.64-0.74) | 5.33 |
| Zeng, 2014 | 0.75 (0.74-0.75) | 6.37 |
| Samsen, 2012 | 0.64 (0.63-0.64) | 6.34 |
| Haun, 2009 | 0.59 (0.53-0.65) | 4.98 |
| Kim, 2016 | 0.66 (0.64-0.67) | 6.25 |
| Satoh, 2010 | 0.78 (0.77-0.78) | 6.34 |
| Lin, 2002 | 0.72 (0.71-0.73) | 6.34 |
| Wakabayashi, 2012 | 0.75 (0.74-0.76) | 6.33 |
| Hadaegh, 2009 | 0.53 (0.48-0.58) | 5.30 |
| Zabetian, 2009 | 0.53 (0.48-0.58) | 5.30 |
| Ho, 2003 | 0.72 (0.69-0.73) | 5.96 |
| Mirmiran, 2004 | 0.65 (0.62-0.68) | 5.96 |
| Katulanda, 2011 | 0.71 (0.69-0.73) | 6.18 |
| Overall (I2= 98.8%,P< .001) | 0.66 (0.63-0.69) | 100.0 |
Figure 3.
Random-effects pooled area under the ROC curves (AUC) and test of heterogeneity for waist circumference with cardiovascular disease or cardiometabolic disease for men and women. The dashed lines indicate the null model. Weighted percentages determined by using random effects analysis. Abbreviation: ROC, receiver operating characteristic.
| Study | AUC (95% Confidence Interval) | Weighted % |
|---|---|---|
| Men | ||
| Al-Lawati, 2008 | 0.71 (0.68-0.74) | 5.06 |
| Narisawa, 2008 | 0.69 (0.65-0.73) | 4.26 |
| Talaei, 2012 | 0.59 (0.55-0.63) | 4.45 |
| Wildman, 2004 | 0.52 (0.46-0.58) | 2.68 |
| Ptanga, 2005 | 0.73 (0.67-0.79) | 2.88 |
| Zeng, 2014 | 0.71 (0.71-0.71) | 7.89 |
| Samsen, 2012 | 0.68 (0.67-0.69) | 7.47 |
| Haun, 2009 | 0.73 (0.67-0.79) | 2.88 |
| Kim, 2016 | 0.62 (0.61-0.64) | 7.09 |
| Lin, 2002 | 0.69 (0.69-0.70) | 7.77 |
| Siren, 2012 | 0.86 (0.81-0.91) | 3.42 |
| Wakabayashi, 2012 | 0.72 (0.71-0.72) | 7.81 |
| Cheong, 2013 | 0.69 (0.69-0.70) | 7.61 |
| Hadaegh, 2009 | 0.60 (0.56-0.64) | 4.35 |
| Yoshida, 2009 | 0.61 (0.55-0.67) | 2.72 |
| Zabetian, 2009 | 0.58 (0.51-0.64) | 2.64 |
| Ho, 2003 | 0.78 (0.75-0.81) | 5.50 |
| Mirmiran, 2004 | 0.70 (0.66-0.74) | 4.45 |
| Lee, 2010 | 0.67 (0.62-0.72) | 3.57 |
| Katulanda, 2011 | 0.71 (0.68-0.74) | 5.50 |
| Overall (I2= 94.7%,P< .001) | 0.69 (0.67-0.70) | 100.0 |
| Women | ||
| Al-Lawati, 2008 | 0.73 (0.69-0.76) | 4.58 |
| Narisawa, 2008 | 0.76 (0.70-0.82) | 4.33 |
| Talaei, 2012 | 0.59 (0.55-0.63) | 4.53 |
| Foucan, 2002 | 0.76 (0.74-0.78) | 4.64 |
| Wildman, 2004 | 0.51 (0.51-0.51) | 4.68 |
| Ptanga, 2005 | 0.66 (0.61-0.71) | 4.48 |
| Pua, 2004 | 0.72 (0.68-0.76) | 4.53 |
| Zeng, 2014 | 0.76 (0.76-0.76) | 4.68 |
| Samsen, 2012 | 0.67 (0.67-0.68) | 4.67 |
| Haun, 2009 | 0.66 (0.61-0.71) | 4.46 |
| Kim, 2016 | 0.72 (0.71-0.73) | 4.66 |
| Lin, 2002 | 0.74 (0.73-0.74) | 4.67 |
| Wakabayashi, 2012 | 0.75 (0.74-0.75) | 4.67 |
| Cheong, 2013 | 0.71 (0.71-0.72) | 4.67 |
| Almeida de, 2009 | 0.70 (0.63-0.77) | 4.26 |
| Hadaegh, 2009 | 0.60 (0.55-0.65) | 4.48 |
| Yoshida, 2009 | 0.66 (0.61-0.71) | 4.49 |
| Zabetian, 2009 | 0.57 (0.49-0.64) | 4.21 |
| Ho, 2003 | 0.74 (0.71-0.77) | 4.60 |
| Mirmiran, 2004 | 0.68 (0.66-0.70) | 4.64 |
| Lee, 2010 | 0.77 (0.72-0.82) | 4.46 |
| Katulanda, 2011 | 0.72 (0.70-0.74) | 4.64 |
| Overall (I2= 99.7%,P< .001) | 0.69 (0.64-0.74) | 100.0 |
Figure 4.
Random-effects pooled area under the ROC curves (AUC) and test of heterogeneity for waist-to-hip ratio with cardiovascular disease or cardiometabolic disease for men and women. The dashed lines indicate the null model. Weighted percentages determined by using random effects analysis. Abbreviation: ROC, receiver operating characteristic.
| Study | AUC (95% Confidence Interval) | Weighted % |
|---|---|---|
| Men | ||
| Al-Lawati, 2008 | 0.77 (0.74-0.80) | 10.27 |
| Ptanga, 2005 | 0.76 (0.70-0.82) | 8.65 |
| Haun, 2009 | 0.76 (0.70-0.82) | 8.65 |
| Lin, 2002 | 0.68 (0.67-0.69) | 11.68 |
| Hadaegh, 2009 | 0.62 (0.58-0.66) | 10.06 |
| Li, 2014 | 0.61 (0.58-0.63) | 11.10 |
| Zabetian, 2009 | 0.57 (0.50-0.64) | 8.12 |
| Ho, 2003 | 0.77 (0.73-0.81) | 10.13 |
| Mirmiran, 2004 | 0.70 (0.66-0.74) | 10.13 |
| Katulanda, 2011 | 0.68 (0.65-0.71) | 10.78 |
| Overall (I2= 92.6%,P< .001) | 0.69 (0.66-0.73) | 100.0 |
| Women | ||
| Al-Lawati, 2008 | 0.80 (0.77-0.83) | 9.30 |
| Ptanga, 2005 | 0.75 (0.70-0.80) | 7.56 |
| Pua, 2004 | 0.69 (0.64-0.74) | 7.56 |
| Haun, 2009 | 0.75 (0.70-0.80) | 7.56 |
| Lin, 2002 | 0.72 (0.72-0.73) | 10.43 |
| Almeida de, 2009 | 0.74 (0.67-0.81) | 5.96 |
| Hadaegh, 2009 | 0.66 (0.61-0.70) | 7.90 |
| Li, 2014 | 0.67 (0.64-0.69) | 9.72 |
| Zabetian, 2009 | 0.58 (0.50-0.65) | 5.66 |
| Ho, 2003 | 0.74 (0.71-0.77) | 9.23 |
| Mirmiran, 2004 | 0.66 (0.66-0.70) | 9.23 |
| Katulanda, 2011 | 0.68 (0.66-0.70) | 9.91 |
| Overall (I2= 89.8%,P< .001) | 0.71 (0.68-0.73) | 100.0 |
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