Comparative Discriminative Performance of Anthropometric Indices for Detecting Elevated Blood Pressure and Dysglycaemia in Young Medical Students: Waist-To-Height Ratio Versus Body-Mass Index
Main Article Content
Abstract
Background: Body-mass index (BMI) is the usual screening measure of adiposity but does not capture central fat distribution, which is more strongly linked to cardiometabolic risk, particularly in Asian Indians. We compared the discriminative performance of five anthropometric indices for detecting elevated blood pressure (BP) and dysglycaemia in young medical students.
Methods: Cross-sectional study of 311 MBBS students aged 18–24 years (the same cohort as our companion burden analysis). BMI, waist circumference (WC), waist–hip ratio (WHR), waist–height ratio (WHtR) and neck circumference (NC) were related to systolic and diastolic BP and fasting blood glucose (FBG) using Pearson and age/sex-adjusted partial correlations, multiple linear regression, logistic regression, and receiver-operating-characteristic (ROC) analysis. Elevated BP (composite of elevated BP or hypertension, 2017 ACC/AHA) and dysglycaemia (FBG ≥ 100 mg/dL, ADA) were the binary outcomes.
Results: WHtR showed the strongest correlations with SBP (r = 0.58), DBP (r = 0.53) and FBG (r = 0.37; all P < 0.001), exceeding WC, BMI, WHR and NC; the ranking persisted after adjustment for age and sex. In regression, WHtR and WC were independent predictors, whereas BMI lost significance once central-adiposity measures were included, and categorical high-risk analyses were directionally concordant. WHtR had the highest area under the ROC curve (AUC) for both elevated BP (0.80; 95% CI 0.75–0.85) and dysglycaemia (0.74; 0.67–0.81), followed by WC (0.74, 0.69), with BMI (0.66, 0.61) and NC (0.63, 0.58) lowest.
Conclusions: WHtR was the best-performing simple anthropometric screen for early elevated BP and dysglycaemia in young adults and outperformed BMI. Campus and community screening should incorporate WHtR, operationalized by the message “keep your waist below half your height.”