Role of waist circumference-to-height ratio in assessing adiposity, predicting type 2 diabetes mellitus and other cardiometabolic diseases

Although body mass index (BMI) is widely used as a simple tool to evaluate obesity, some drawbacks and inaccuracies have been shown. It is known that visceral adipose tissue is more closely related to cardiometabolic risks and all-cause mortality; however, accurate measurement methods of visceral fat (magnetic resonance imaging and computed tomography) cannot be widely used. Therefore, simple but accurate alternatives are valuable. Studies have shown that waist circumference-to-height ratio (WHtR) might be a superior and more accurate variable in assessing central or visceral adiposity as well as predicting risks of diabetes and other cardiometabolic diseases. In addition, it has the same threshold for the overall population irrespective of ethnicity, age and sex. Therefore, because of its advantages, WHtR is worth popularization and application. In this review, we will focus on the evidence on WHtR as a better and simpler anthropometric index comparing with other indices in assessing adiposity, and predicting type 2 diabetes and other cardiometabolic diseases.