Association between maternal vitamin D deficiency and pregnancy outcomes: a prospective study

Background: Cardiovascular risk is strongly influenced by excess adiposity, particularly abdominal fat accumulation. Body mass index (BMI) is routinely used to classify general adiposity but does not describe fat distribution. Waist-to-height ratio (WHtR) incorporates waist circumference relative to stature and may therefore better reflect central adiposity and associated metabolic risk. The aim is to compare WHtR and BMI for identifying increased cardiovascular risk among urban adults in Hyderabad, Telangana. Methods: A cross-sectional observational study was conducted among 70 adults aged 18–60 years. Weight, height, waist circumference and blood pressure were measured using standard procedures. Fasting plasma glucose and lipid profile were assessed. BMI and WHtR were calculated, and increased cardiovascular risk was defined as the presence of at least two non-anthropometric cardiometabolic abnormalities: elevated blood pressure, elevated fasting glucose, hypertriglyceridaemia and/or reduced HDL-C. Associations were examined using group comparisons and Pearson correlation. Receiver operating characteristic (ROC) analysis was used to compare the discriminatory performance of BMI and WHtR. Results: The mean age was 41.6±10.8 years. BMI ≥25 kg/m² was present in 39 (55.7%) participants, whereas WHtR ≥0.50 was present in 45 (64.3%). Participants with WHtR ≥0.50 had significantly higher frequencies of elevated blood pressure, elevated fasting glucose, hypertriglyceridaemia, reduced HDL-C and clustering of at least two cardiometabolic abnormalities. WHtR correlated more strongly than BMI with the measured cardiometabolic variables. ROC analysis showed an AUC of 0.82 (95% CI: 0.72–0.92) for WHtR and 0.71 (95% CI: 0.59–0.83) for BMI. Conclusions: In this study population, WHtR showed better discrimination than BMI for the defined cardiometabolic risk outcome. WHtR may be a useful adjunct to BMI in simple cardiovascular risk screening among urban Indian adults.