Obesity has a strong association with some important risk factors of cardiovascular disease, including diabetes mellitus, hypertension, and metabolic syndrome. This study was carried out to compare the predictive ability of six obesity indices including body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), conicity index, and abdominal volume index (AVI) for the identification of people at the risk of fatal and non-fatal cardiovascular disease (CVD) events, in a population based cohort study.

In the present study, data of 5147 individuals whose outcomes were available in second comprehensive evaluation (in 2016-2017) of participants were considered. In this step, the outcomes of patients, including the fatal and non-fatal CVD events, were obtained based on the report of patients, closed family of patients and evaluation of medical records. The related data of obesity measures were obtained from data of our first comprehensive evaluation of participants in 2009-2010. Receiver operating characteristic (ROC) analyses were conducted in which obesity measures and CVD events were considered associated predictors and outcomes, respectively.

The highest performance was related to the conicity index for fatal CVD events, non-fatal CVD events and also fatal and non-fatal CVD events with area under curves (AUCs) of 0.770 (95% CI (confidence interval)=0.712-0.828), 0.639 (95% CI=0.595-0.683), and 0.674 (95% CI=0.637-0.711) in men and AUCs of 0.808 (95% CI=0.742-0.875), 0.659 (95% CI=0.600-0.719), and 0.697 (95% CI=0.648-0.747) in women, respectively.

The results showed that conicity index had the highest performance to predict the fatal and non-fatal CVD events. Thus, the authors suggest that this index may be appropriate for application, particularly, in clinical cardiology settings.