Waist-to-height ratio and the atherogenic index of plasma: parallels or intersections in cardiovascular diseases?

M.V. Moiseeva, I.A. Viktorova, D.B. Uralbaeva, A.M. Adyrbaev

Omsk State Medical University, Omsk

Background: the incidence of circulatory system diseases remains high, highlighting the relevance and importance of prevention and focusing attention on risk factor management. Anthropometric parameters associated with excessive visceral fat accumulation, as well as laboratory markers (such as dyslipidemia and impaired glucose tolerance), represent powerful contributors to the development and progression of cardiovascular diseases (CVD).

Aim: to compare the atherogenic index of plasma (AIP) and waist-to-height ratio (WHtR) in respondents with and without CVD across different levels of glycemia. 

Patients and Methods: a random sample analysis was conducted in the Omsk region population (n=1637), aged 25–64 years. Patients were divided into four groups according to blood glucose levels: 5.6 mmol/L up to and including 6.0 mmol/L — 176 patients (group 1); 6.1 mmol/L up to and including 6.9 mmol/L — 100 patients (group 2); 7.0 mmol/L and higher — 86 patients (group 3); less than 5.6 mmol/L — 1144 patients (group 4).

Results and Discussion: significant differences in AIP were detected between respondents without CVD with WHtR <0.5 (n=404) and WHtR ≥0.5 (n=426) (U=2.4658; p=0.0137). However, no significant differences in AIP were found among respondents with CVD between those with WHtR <0.5 (n=195) and WHtR ≥0.5 (n=611) (U=1.0966; p=0.2728). Comparisons of AIP among respondents with WHtR <0.5 and varying glycemic levels revealed significant differences based on glycemic group (Kruskal-Wallis test, H (3)=47.43, p=0.000). Similarly, significant differences in AIP were observed in respondents with WHtR ≥0.5 depending on their glycemic status (H (3)=67.93, p=0.000).

Conclusion: statistical analysis emphasizes the association between changes in AIP and hyperglycemia, starting at a plasma glucose level of 5.6 mmol/L and above. The current Russian criteria for fasting hyperglycemia in venous plasma (≥6.1 mmol/L) appear to be overestimated, as hyperglycemia starting at 5.6 mmol/L more accurately reflects a parallel increase in AIP, which characterizes the activation of the atherosclerotic process in individuals with elevated WHtR.

Keywords: atherogenic index, hyperglycemia, cardiovascular diseases, ESSE-RF2, waist-to-height ratio.

For citation: Moiseeva M.V., Viktorova I.A., Uralbaeva D.B., Adyrbaev A.M. Waist-to-height ratio and the atherogenic index of plasma: parallels or intersections in cardiovascular diseases? RMJ. 2025;5:13–16. DOI: 10.32364/2225-2282-2025-5-3