The Waist-to-Height Ratio and Incidence of High LDL Cholesterol in Japanese: A Retrospective Cohort Study
Abstract
AIM: Low-density lipoprotein cholesterol (LDL-C) is a major contributor to atherosclerotic cardiovascular disease (CVD). The waist-to-height ratio (WHtR) has been proposed as a practical marker of central obesity; however, evidence linking WHtR with incident high LDL-C levels in Japanese populations remains limited. This study investigated the association between WHtR and future LDL-C elevation in a community-based cohort in Japan. METHODS: This retrospective cohort study included 3,934 adults aged 30-74 years without dyslipidemia at baseline from the Iki Epidemiological Study of Atherosclerosis and Chronic Kidney Disease. The participants were followed between 2008 and 2019. WHtR was categorized into sex-specific quartiles. Incident high LDL-C was defined as LDL-C ≥ 3.62 mmol/L or initiation of lipid-lowering therapy. Cox proportional hazards models were used to estimate the hazard ratios (HRs), after adjusting for demographic, lifestyle, and clinical factors. RESULTS: During a mean follow-up period of 5.02 years, 466 females and 424 males developed high LDL-C levels. Among females, the adjusted hazard ratio (HR) (95% confidence interval [CI]) for quartile 4 versus quartile 1 was 1.95 (1.41-2.71; p for trend ＜0.0001). Among males, the corresponding adjusted HR (95% CI) was 1.61 (1.18-2.21; p for trend = 0.001). A higher WHtR was associated with an increased risk of incident high LDL-C in both sexes (trend p＜0.01). A WHtR threshold of approximately 0.5 corresponded to a notable increase in risk. CONCLUSION: A Higher WHtR was associated with an increased risk of incident high LDL-C. These findings suggest that WHtR may be a useful anthropometric indicator for identifying individuals at risk, although further studies are required.
Related
- Joint association of the cholesterol–high-density lipoprotein–glucose index and waist-to-height ratio with incident cardiovascular disease in a high-risk Chinese cohort
- Association between the cholesterol-high-density lipoprotein-glucose index and the incidence of new-onset diabetes in patients with chronic gastrointestinal diseases: A prospective cohort study.
- Skin‐Related Adverse Events in Patients Treated With Apalutamide Versus Enzalutamide for Prostate Cancer: A Japanese Real‐World Database Study (A Retrospective Cohort Study)
- Association between maternal dysglycaemia and adverse perinatal outcomes: A retrospective cohort study using a Japanese mother–infant-linked claims database
- HDL Functionality, Cholesterol-Related Biomarkers and Incidence of Dementia: A Case–Cohort Study in Older Adults at High Cardiovascular Risk
BibTeX
@article{fujii2026waisttoheight,
title = {{The Waist-to-Height Ratio and Incidence of High LDL Cholesterol in Japanese: A Retrospective Cohort Study}},
author = {Takako Fujii and Shintaro Ishida and Makiko Abe and Miki Kawazoe and Toshiki Maeda and Chikara Yoshimura and Yori Inoue and Kazuhiro Tada and Koji Takahashi and Kenji Ito and Kosuke Masutani and Hisatomi Arima},
journal = {Journal of Atherosclerosis and Thrombosis},
year = {2026},
month = sep,
doi = {10.5551/jat.66242},
url = {https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66242/_article},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - The Waist-to-Height Ratio and Incidence of High LDL Cholesterol in Japanese: A Retrospective Cohort Study
AU - Takako Fujii
AU - Shintaro Ishida
AU - Makiko Abe
AU - Miki Kawazoe
AU - Toshiki Maeda
AU - Chikara Yoshimura
AU - Yori Inoue
AU - Kazuhiro Tada
AU - Koji Takahashi
AU - Kenji Ito
AU - Kosuke Masutani
AU - Hisatomi Arima
PY - 2026
DA - 2026/09/01
JO - Journal of Atherosclerosis and Thrombosis
DO - 10.5551/jat.66242
UR - https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66242/_article
AB - AIM: Low-density lipoprotein cholesterol (LDL-C) is a major contributor to atherosclerotic cardiovascular disease (CVD). The waist-to-height ratio (WHtR) has been proposed as a practical marker of central obesity; however, evidence linking WHtR with incident high LDL-C levels in Japanese populations remains limited. This study investigated the association between WHtR and future LDL-C elevation in a community-based cohort in Japan. METHODS: This retrospective cohort study included 3,934 adults aged 30-74 years without dyslipidemia at baseline from the Iki Epidemiological Study of Atherosclerosis and Chronic Kidney Disease. The participants were followed between 2008 and 2019. WHtR was categorized into sex-specific quartiles. Incident high LDL-C was defined as LDL-C ≥ 3.62 mmol/L or initiation of lipid-lowering therapy. Cox proportional hazards models were used to estimate the hazard ratios (HRs), after adjusting for demographic, lifestyle, and clinical factors. RESULTS: During a mean follow-up period of 5.02 years, 466 females and 424 males developed high LDL-C levels. Among females, the adjusted hazard ratio (HR) (95% confidence interval [CI]) for quartile 4 versus quartile 1 was 1.95 (1.41-2.71; p for trend ＜0.0001). Among males, the corresponding adjusted HR (95% CI) was 1.61 (1.18-2.21; p for trend = 0.001). A higher WHtR was associated with an increased risk of incident high LDL-C in both sexes (trend p＜0.01). A WHtR threshold of approximately 0.5 corresponded to a notable increase in risk. CONCLUSION: A Higher WHtR was associated with an increased risk of incident high LDL-C. These findings suggest that WHtR may be a useful anthropometric indicator for identifying individuals at risk, although further studies are required.
SN - 1880-3873
SN - 1340-3478
ER -