Nutr Metab Cardiovasc Dis. 2026 Feb 23:104639. doi: 10.1016/j.numecd.2026.104639. Online ahead of print.
ABSTRACT
BACKGROUND AND AIM: Anthropometric measures and derived ratios effectively predict cardiovascular disease (CVD) mortality. In this study, we aimed to compare waist-to-thigh ratio (WTR) with more common measures for predicting CVD mortality.
METHODS AND RESULTS: This study included 5661 U.S. adults from the 1999-2002 National Health and Nutrition Examination Survey, linked with 2019 mortality status from the National Death Index (768 CVD deaths). Anthropometric measures, including waist circumference (WC), thigh circumference (TC), BMI, waist-to-BMI ratio (WBR), waist-to-height ratio (WHtR), and WTR, were assessed at baseline. Hazards ratios (HR) and 95th confidence intervals (CI) were calculated for each anthropometric measure across quartiles in relation to CVD mortality after adjusting for traditional CVD risk factors and accounting for multi-stage sampling design. Study results showed that, compared to the lowest quartile, successive quartiles of WTR were significantly associated with greater HRs for CVD mortality (1.34 (0.88-2.03), 1.26 (0.90-1.76), and 1.62 (1.21-2.16, respectively, p trend = 0.003). Stronger associations were observed among adults aged 75 and above, with HR (95% CI) for the highest versus lowest WTR quartile of 2.34 (1.70-3.22) (p trend <0.001). However, no significant associations were observed for other anthropometric measures and CVD mortality.
CONCLUSIONS: In this nationally representative U.S. cohort, WTR was a stronger predictor of CVD mortality than WC, TC, BMI, WBR, or WHtR, particularly among participants aged ≥75 years. Incorporating WTR into traditional CVD risk models may more sensitively identify individuals at risk of CVD death.
PMID:41934045 | DOI:10.1016/j.numecd.2026.104639