Age-related differences in recommended anthropometric cut-off point validity to identify
cardiovascular risk factors in ostensibly healthy women
Sammanfattning
Aim: To investigate validity of widely recommended anthropometric and total fat percentage
cut-off points in screening for cardiovascular risk factors in women of different ages. Methods: A
population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and
elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was
estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ?25 and
?30), waist circumference (WC; ?80 cm and ?88 cm) and total fat percentage (TF; ?35%) cut-off points
for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated
for each age. Cut-off points yielding high sensitivity together with modest specificity were considered
valid. Women reporting hospital admission for cardiovascular disease were excluded. Results: The
sensitivity of WC ?80 cm for one or more risk factors was ~60% in younger and middle-aged women,
and 80% in elderly women. The specificity of WC ?80 cm for one or more risk factors was 69%, 57%
and 40% at the three ages (p < .05 for age trends). WC ?80 cm yielded ~80% sensitivity for two or
more risk factors across all ages. However, specificity decreased with increasing age (p < .0001),
being 33% in elderly. WC ?88 cm provided better specificity in elderly women. BMI and TF % cut-off
points were not better than WC. Conclusions: Validity of recommended anthropometric cut-off points
in screening asymptomatic women varies with age. In younger and middle-age, WC ?80 cm yielded
high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or
more risk factor was less than optimal. WC ?88 cm showed better validity than WC ?80 cm in elderly.
Our results support age-specific screening cut-off points for women.