Within-person variability in calculated risk factors: Comparing the aetiological association of adiposity ratios with risk of coronary heart disease

Wormser, David; White, Ian R; Thompson, Simon G; Wood, Angela M
June 2013
International Journal of Epidemiology;Jun2013, Vol. 42 Issue 3, p849
Academic Journal
Background Within-person variability in measured values of a risk factor can bias its association with disease. We investigated the extent of regression dilution bias in calculated variables and its implications for comparing the aetiological associations of risk factors.Methods Using a numerical illustration and repeats from 42 300 individuals (12 cohorts), we estimated regression dilution ratios (RDRs) in calculated risk factors [body-mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)] and in their components (height, weight, waist circumference, and hip circumference), assuming the long-term average exposure to be of interest. Error-corrected hazard ratios (HRs) for risk of coronary heart disease (CHD) were compared across adiposity measures per standard-deviation (SD) change in: (i) baseline and (ii) error-corrected levels.Results RDRs in calculated risk factors depend strongly on the RDRs, correlation, and comparative distributions of the components of these risk factors. For measures of adiposity, the RDR was lower for WHR [RDR: 0.72 (95% confidence interval 0.65–0.80)] than for either of its components [waist circumference: 0.87 (0.85–0.90); hip circumference: 0.90 (0.86–0.93) or for BMI: 0.96 (0.93–0.98) and WHtR: 0.87 (0.85–0.90)], predominantly because of the stronger correlation and more similar distributions observed between waist circumference and hip circumference than between height and weight or between waist circumference and height. Error-corrected HRs for BMI, waist circumference, WHR, and WHtR, were respectively 1.24, 1.30, 1.44, and 1.32 per SD change in baseline levels of these variables, and 1.24, 1.27, 1.35, and 1.30 per SD change in error-corrected levels.Conclusions The extent of within-person variability relative to between-person variability in calculated risk factors can be considerably larger (or smaller) than in its components. Aetiological associations of risk factors should be compared through the use of error-corrected HRs per SD change in error-corrected levels of these risk factors.


Related Articles

  • Effects of Obesity on the Impact of Short-Term Changes in Anthropometric Measurements on Coronary Heart Disease in Women. Mohebi, Reza; Bozorgmanesh, Mohammadreza; Azizi, Fereidoun; Hadaegh, Farzad // Mayo Clinic Proceedings;May2013, Vol. 88 Issue 5, p487 

    Objective: To assess the impact of short-term changes in body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio on the risk of future coronary heart disease (CHD) among women. Participants and Methods: The study sample consisted of 2468 women aged 30...

  • Abdominal Fat Distribution and Serum Lipids in Patients With and without Coronary Heart Disease. Sadeghi, Masoumeh; Pourmoghaddas, Zahra; Hekmatnia, Ali; Sanei, Hamid; Tavakoli, Babak; Tchernof, Andre; Roohafza, Hamidreza; Sarrafzadegan, Nizal // Archives of Iranian Medicine (AIM);Mar2013, Vol. 16 Issue 3, p149 

    Objective: To investigate the association between obesity indices, abdominal fat distribution, and lipid profile in patients with stable angina (SA). Methods: Body weight, height, waist circumference (WC), body mass index (BMI), and waist/height ratio (WHtR) of 123 patients with SA who underwent...

  • Can self-reported height and weight be relied upon? Lois, K.; Kumar, S.; Williams, N.; Birrell, L. // Occupational Medicine;Dec2011, Vol. 61 Issue 8, p590 

    Aims To assess whether self-reported height and weight [and body mass index (BMI)] can be used in workplace health promotion campaigns.Methods Volunteers were instructed how to measure their weight, height and waist circumference (WC). Self-reported values were compared with direct measurements....

  • Body Mass Index and Mortality in a General Population Sample Women of Men and Women. Dorn, Joan M.; Schisterman, Enrique F.; Winkelstein, Warren; Trevisan, Maurizio // American Journal of Epidemiology;1997, Vol. 146 Issue 11, p919 

    The objective of this research was to investigate the long-term relation between body mass index (BMI) and mortality from all causes and from specific causes in the general population. A 29-year follow-up study was conducted in a random sample of white men (n=611) and women (n=697) aged...

  • Anemia in relation to body mass index and waist circumference among chinese women. Yu Qin; Melse-Boonstra, Alida; Xiaoqun Pan; Baojun Yuan; Yue Dai; Jinkou Zhao; Zimmermann, Michael B.; Kok, Frans J.; Minghao Zhou; Zumin Shi // Nutrition Journal;2013, Vol. 12, p1 

    Background: This study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified...

  • Obesity. Russell's, David; Ashby, Carrie // Pulse;Dec2015, p48 

    The article presents questions and answers on orlistat, bariatric surgery and risk factors linked with obesity, how to measure waist circumference and body mass index classification.

  • The Effect of Elevated Body Mass Index on Ischemic Heart Disease Risk: Causal Estimates from a Mendelian Randomisation Approach. Nordestgaard, Børge G.; Palmer, Tom M.; Benn, Marianne; Zacho, Jeppe; Tybjærg-Hansen, Anne; Smith, George Davey; Timpson, Nicholas J. // PLoS Medicine;May2012, Vol. 9 Issue 5, p1 

    Background: Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal. Methods and...

  • Nadwaga i otyÅ‚ość kobiet w okresie okoÅ‚omenopauzalnym mierzone metodÄ… bioimpedancji elektrycznej. Dąbrowska, Jolanta; Naworska, Beata; Dąbrowska-Galas, Magdalena; Wodarska, Magdalena; Skrzypulec-Plinta, Violetta // Menopausal Review / Przeglad Menopauzalny;2013, Vol. 12 Issue 3, p260 

    Introduction: Increased body mass is one of the biggest health problems among women aged 55-65. Obesity has been implicated as one of the major risk factors for coronary heart disease, diabetes and hypertension. Moreover, obesity can contribute to incontinence and musculoskeletal diseases, in...

  • Childhood Obesity -- A Looming Disaster. Abrams, Jonathan // Travel Medicine Advisor;Mar2008, Vol. 18 Issue 3, p15 

    This remarkable study is a population analysis of a huge cohort of children in Denmark who were followed, since 1930 or later, for the presence of coronary heart disease (CHD), and had all mandatory annual examinations at schools in Copenhagen. The study analyzed data from 277,000 children, aged...


Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics