so far , anthropometric variables and their relation to conventional coronary risk factors in railway employees have been inadequately studied in india . to assess anthropometric variables and their relation to coronary risk factors ,
this cross - sectional survey was carried out in solapur division of the central railway in the year 2004 .
the purpose of this study was to examine the association of obesity with cad risk factors by different anthropometric variables .
this particular section of the population was selected , as it comprises all classes of employees , including both sexes , sedentary and nonsedentary job workers of various socioeconomic groups , religions , and from different parts of india .
this study was designed to investigate conventional cad risk factors and their relation to anthropometric variables among the solapur division railway employees .
this study was conducted among the railway employees of solapur division of the central railway .
a proforma was prepared that incorporated information regarding demography ( age and sex ) , anthropometric ( height in meter , weight in kilograms , waist and hip circumferences in centimeters ) variables , occupation ( sedentary or nonsedentary ) , physical examination ( pulse , blood pressure ) , clinical data ( history of diabetes hypertension , smoking , tobacco chewing , exercise ) , and biochemical investigations [ fasting blood sugar level ( bsl ) and complete lipid profile ] .
anthropometric variables were calculated by using the above measurements for body mass index ( bmi ) , waist circumference ( wc ) , waist - to - hip ratio ( whr ) , waist - to - height ratio ( whtr ) , and abdominal volume index ( avi ) .
all the eligible employees of both sexes underwent physical , anthropometric examination , and biochemical investigations according to the standard guidelines used earlier .
a total of 995 railway employees participated in this cross - sectional survey with age  30 and  60 years .
railway employees were chosen from railway stations , divisional railway mandal office , railway police force ( rpf ) and railway hospitals . according to the nature of their job ,
there were 872 men of whom 484 ( 55.5% ) were of age < 45 years and 388 ( 44.5% ) were of age  45 years .
a total of 123 were females , 58 ( 48% ) were of age < 45 years and 65 ( 52% ) were of age  45 years .
blood pressure was measured using a standard mercury sphygmomanometer under standard conditions as mentioned in cardiovascular survey methods .
biochemical investigations were performed on an automated analyzer by using the kit provided by accurex biomedical pvt . ltd .
( iso 13485 : 2003 , iso 9001 : 2008 & ce certified mumbai , india ) .
was measured by cholesterol oxidase ( chod) phenol + aminophenazone ( pap ) enzymatic colorimetric technique .
triglyceride ( trg ) was measured by glycerol-3-phosphate oxidase ( gpo) peroxidase ( pod ) enzymatic technique .
bsl fasting was done by glucose oxidase ( god )  peroxidase ( pod ) enzymatase by autoenzyme technique .
each person was examined for height , weight , wc , and hip circumference without shoes and chappals with minimal clothing as per cardiovascular survey methods .
bmi was calculated by formula of weight in kg / height m. whr was calculated by wc / hc in centimeters .
avi was calculated using volume formulas for cylinder ( v = rh ) and vertical cone v = ( 1/3)rh . the formula developed was avi = [ 2 cm ( waist ) + 0.7 cm ( wc  hc)]/1000 , which estimates overall abdominal volume between symphysis of pubis and xiphoid appendix and theoretically includes intra - abdominal fat and adipose tissue volumes . 

a smoker in india consumes tobacco in the form of bidi / cigarettes and chewing tobacco .
a person smoking one or more cigarettes or bidis per day at the time of study was considered as a smoker and one chewing tobacco currently , a tobacco chewer . in the present study ,
tobacco consumption in the form of smoking and in the form of tobacco chewing were grouped separately.physical activity according to the type of job were classified as , nonsedentary job ( moderate to heavy physical activity)sedentary job ( low physical activity ) 
 physical activity was classified into 2 levels , moderate to high physical activity was referred as nonsedentary ( rpf , drivers , gangmen , and others)low physical activity referred ( sedentary ) to people involved in office work , research work , and so on . 
 
a smoker in india consumes tobacco in the form of bidi / cigarettes and chewing tobacco .
a person smoking one or more cigarettes or bidis per day at the time of study was considered as a smoker and one chewing tobacco currently , a tobacco chewer . in the present study ,
tobacco consumption in the form of smoking and in the form of tobacco chewing were grouped separately .
physical activity according to the type of job were classified as , nonsedentary job ( moderate to heavy physical activity ) sedentary job ( low physical activity ) 
 physical activity was classified into 2 levels , moderate to high physical activity was referred as nonsedentary ( rpf , drivers , gangmen , and others ) low physical activity referred ( sedentary ) to people involved in office work , research work , and so on .
cutoffs for high wc were > 85 cm for females and > 90 cm for males .
cutoffs for high avi was calculated by receiver - operator characteristic ( roc ) curve 16.48 liter .
diabetes mellitus ( dm ) : if a subject is a known diabetic on treatment with any bsl or if fasting bsl ( f - bsl ) 126 mg / dl .
dyslipidemia was defined as if , t - cho  200 mg / dl , ldl , cholesterol  130 mg / dl , hdl , cholesterol 40 mg / dl , trg  150 mg / dl .
hypertension was labeled if blood pressure  140 mmhg sbp and 90 mmhg dbp or known to be hypertensive on treatment with any blood pressure .
the data were pooled , computerized , and analyzed by evaluation version of epi info .
6 [ ( epi info is public domain statistical software for epidemiology developed by centers for disease control and prevention ( cdc ) in atlanta , georgia ( usa ) ] .
correlation of anthropometric variables and coronary risk factors in different age groups were determined using r and multiple linear regression analysis .
roc curve is used to find out the cutoff point for particular value of a test as a diagnostic test .
cutoff values of whtr and avi were calculated by using this curve as a tool for diagnosing central obesity . correlation ( r ) : r = 0.8 ( high correlation coefficient ) , r= 0.40.7 ( moderate correlation ) , and r= 0.3 and above ( low correlation coefficient ) .
each person was examined for height , weight , wc , and hip circumference without shoes and chappals with minimal clothing as per cardiovascular survey methods .
bmi was calculated by formula of weight in kg / height m. whr was calculated by wc / hc in centimeters .
avi was calculated using volume formulas for cylinder ( v = rh ) and vertical cone v = ( 1/3)rh . the formula developed was avi = [ 2 cm ( waist ) + 0.7 cm ( wc  hc)]/1000 , which estimates overall abdominal volume between symphysis of pubis and xiphoid appendix and theoretically includes intra - abdominal fat and adipose tissue volumes .

 a smoker in india consumes tobacco in the form of bidi / cigarettes and chewing tobacco .
a person smoking one or more cigarettes or bidis per day at the time of study was considered as a smoker and one chewing tobacco currently , a tobacco chewer . in the present study ,
tobacco consumption in the form of smoking and in the form of tobacco chewing were grouped separately.physical activity according to the type of job were classified as , nonsedentary job ( moderate to heavy physical activity)sedentary job ( low physical activity ) 
 physical activity was classified into 2 levels , moderate to high physical activity was referred as nonsedentary ( rpf , drivers , gangmen , and others)low physical activity referred ( sedentary ) to people involved in office work , research work , and so on . 
 
a smoker in india consumes tobacco in the form of bidi / cigarettes and chewing tobacco .
a person smoking one or more cigarettes or bidis per day at the time of study was considered as a smoker and one chewing tobacco currently , a tobacco chewer . in the present study ,
tobacco consumption in the form of smoking and in the form of tobacco chewing were grouped separately .
physical activity according to the type of job were classified as , nonsedentary job ( moderate to heavy physical activity ) sedentary job ( low physical activity ) 
 physical activity was classified into 2 levels , moderate to high physical activity was referred as nonsedentary ( rpf , drivers , gangmen , and others ) low physical activity referred ( sedentary ) to people involved in office work , research work , and so on .
cutoffs for high wc were > 85 cm for females and > 90 cm for males .
cutoffs for high avi was calculated by receiver - operator characteristic ( roc ) curve 16.48 liter .
diabetes mellitus ( dm ) : if a subject is a known diabetic on treatment with any bsl or if fasting bsl ( f - bsl ) 126 mg / dl .
dyslipidemia was defined as if , t - cho  200 mg / dl , ldl , cholesterol  130 mg / dl , hdl , cholesterol 40 mg / dl , trg  150 mg / dl .
hypertension was labeled if blood pressure  140 mmhg sbp and 90 mmhg dbp or known to be hypertensive on treatment with any blood pressure .
the data were pooled , computerized , and analyzed by evaluation version of epi info . 6 [ ( epi info is public domain statistical software for epidemiology developed by centers for disease control and prevention ( cdc ) in atlanta , georgia ( usa ) ] .
correlation of anthropometric variables and coronary risk factors in different age groups were determined using r and multiple linear regression analysis .
roc curve is used to find out the cutoff point for particular value of a test as a diagnostic test .
cutoff values of whtr and avi were calculated by using this curve as a tool for diagnosing central obesity . correlation ( r ) : r = 0.8 ( high correlation coefficient ) , r= 0.40.7 ( moderate correlation ) , and r= 0.3 and above ( low correlation coefficient ) .
a total of 872 ( 87.63% ) were males and 123 ( 12.36% ) were females .
all of them underwent physical examination , and anthropometric measurements for ht , wt , hc ,
and wc , but only 605 males and 95 females underwent biochemical investigations with a response rate of 69.15%in males and 77.23% in females .
the subjects were 45 years of age ; 388 ( 53.35% ) males and 65 ( 52.84% ) females .
high sbp was present in 290 ( 33.25% ) males and 32 ( 26.03% ) females .
high dbp was present in 304 ( 34.86% ) males and 37 ( 30.08% ) females .
physical inactivity was present in 767 ( 87.95% ) males and 102 ( 82.92% ) females .
tobacco chewing was present in 178 ( 20.41% ) males and 12 ( 9.75% ) females .
smoking was present in 151 ( 17.31 % ) males and 2 ( 1.62% ) females .
high bmi was present in 172 ( 19.72% ) males and 73 ( 59.34% ) females .
high wc was present in 412 ( 47.24% ) males and 98 ( 79.67% ) females .
high whr was present in 504 ( 57.79% ) males and 90 ( 73.17% ) females .
high whtr was present in 699 ( 80.16% ) males and 103 ( 83.73% ) females .
high avi was present in 359 ( 41.16% ) males and 35 ( 28.45% ) females .
dm was present in 51 ( 8.42% ) males and 2 ( 2.10% ) females .
low hdl was present in 248 ( 40.99% ) males and 15 ( 15.78% ) females .
high ldl was present in 117 ( 19.33% ) males and 23 ( 24.21% ) females .
high t - cho was present in 151 ( 24.95% ) males and 34 ( 35.78% ) females . high trg was present in 275 ( 45.45% ) males and 19 ( 20% ) females [ table 1 ] .
prevalence of coronary artery disease risk factors in both males and females , all the anthropometric variables were high .
most prevalent obesity index in male population was high whtr . in female population , the most prevalent obesity index was high whtr .
prevalence of overall and central obesity was comparatively more in female population for all the variables as shown in table 2 .
mean age , bmi , and low hdl levels were comparatively higher in females , whereas mean sbp , dbp , trg , whr , wc , and whtr were comparatively higher in males .
standard deviation values of quantitative data in male and female population are shown in table 3 .
prevalence of obesity indices standard deviation values of quantitative data in male and female population total 65 females were with age  45 years and 58 with age < 45 years . in female population , high whr in age  45 years was present in 58 ( 47.15% ) .
in females only high bmi was statistically significant in age  45 years with p value < 0.001 .
males totalling 388 were of the age  45 years and 484 females were < 45 years of age . in male population , 45 years of age , a high whr was present in 262 ( 30.04% ) .
a high bmi in age  45 years was present in 90 ( 10.32% ) .
a high wc in age  45 years was present in 207 ( 23.73% ) .
high avi in age  45 years was present in 279 ( 31.99% ) . in males ,
all anthropometric variables , such as whr , whtr , bmi , wc , and avi , were significantly raised , in the age group  45 years with p value < 0.001 .
bmi had partial positive correlation ( moderate to low ) with coronary risk factors , such as age weight , sbp , dbp , f - bsl , t - cho , ldl cholesterol , trg , and other anthropometric variables .
whr had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , height , weight , sbp , dbp , f - bsl , total , trg , and other anthropometric variables .
whtr had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , weight , sbp , dbp , f - bsl , ldl cholesterol , trg , and other anthropometric variables .
wc had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , weight , height , sbp , dbp , f - bsl , trg , and other anthropometric variables .
avi had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , weight , height , sbp , dbp , f - bsl , trg , and other anthropometric variables [ table 4 ] . in male population , age  45 years had odds ratio of 2.15 with whtr and 1.95 with avi .
sbp had an odds ratio of 2.0 with bmi , 1.47 with wc , and 1.48 with avi .
correlation of anthropometric indices with coronary artery disease risk factors in female population , age  45 years had an odds ratio of 1.673 with bmi .
sedentary job had an odds ratio of 2.0 with whr , 1.86 with wc , and 1.79 with whtr .
sbp had an odds ratio of 1.48 with avi and dbp had an odds ratio of 1.34 with wc .
we have found that age  45 years was better correlated with high values of bmi , wc , whr , whtr , and avi .
high sbp , high dbp , and sedentary job were significantly and positively correlated with high values of bmi , wc , whr , whtr and avi .
high values of bmi , wc , whr , whtr , and avi were negatively associated with physical inactivity .
tobacco and smoking were negatively correlated with high values of bmi , wc , whr , and whtr .
dm was statistically significant and positively associated with high values of bmi , wc , whr , whtr , and avi . in dyslipidemia low hdl was correlated with high values of whr , whtr , and avi , whereas ldl cholesterol , t - cho , and trg were correlated only with high bmi and high whtr in this population [ table 4 ] . in multiple regression analysis a model was utilized that included age , bmi , whr , whtr , wc , avi , sbp , dbp , plasma t - cho , trg , and smoking .
this revealed age , whtr , and whr as an independent determinant of most of the cad risk factors in both genders .
multiple regression analysis for whtr and whr showed that both of them were significantly associated with most of the cad risk factors , such as age  45 years , high sbp , high dbp , dm , low hdl , high ldl , high t - cho , and high trg [ table 5 ] .
relation of anthropometric variables and coronary artery disease risk factors in males and females furthermore , the whr was the single independent variable to all or most of the cad risk factors by multiple regression analysis .
multiple logistic regression analysis revealed whtr and whr were significantly associated with age ( p < 0.001 ) , bmi ( p < 0.001 ) dm ( p = 0.005 ) , sbp ( p < 0.001 ) , dbp ( p < 0.001 ) , low hdl in females , and high trg in males ( p < 0.001 ) [ figure 1 ] .
bmi had partial positive correlation ( moderate to low ) with coronary risk factors , such as age weight , sbp , dbp , f - bsl , t - cho , ldl cholesterol , trg , and other anthropometric variables .
whr had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , height , weight , sbp , dbp , f - bsl , total , trg , and other anthropometric variables .
whtr had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , weight , sbp , dbp , f - bsl , ldl cholesterol , trg , and other anthropometric variables .
wc had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , weight , height , sbp , dbp , f - bsl , trg , and other anthropometric variables .
avi had partial positive correlation ( moderate to low ) with coronary risk factors , such as age , weight , height , sbp , dbp , f - bsl , trg , and other anthropometric variables [ table 4 ] . in male population , age  45 years had odds ratio of 2.15 with whtr and 1.95 with avi . sedentary job had an odds ratio of 1.402 with bmi .
sbp had an odds ratio of 2.0 with bmi , 1.47 with wc , and 1.48 with avi .
correlation of anthropometric indices with coronary artery disease risk factors in female population , age  45 years had an odds ratio of 1.673 with bmi .
sedentary job had an odds ratio of 2.0 with whr , 1.86 with wc , and 1.79 with whtr .
sbp had an odds ratio of 1.48 with avi and dbp had an odds ratio of 1.34 with wc .
we have found that age  45 years was better correlated with high values of bmi , wc , whr , whtr , and avi .
high sbp , high dbp , and sedentary job were significantly and positively correlated with high values of bmi , wc , whr , whtr and avi .
high values of bmi , wc , whr , whtr , and avi were negatively associated with physical inactivity .
tobacco and smoking were negatively correlated with high values of bmi , wc , whr , and whtr .
dm was statistically significant and positively associated with high values of bmi , wc , whr , whtr , and avi .
in dyslipidemia low hdl was correlated with high values of whr , whtr , and avi , whereas ldl cholesterol , t - cho , and trg were correlated only with high bmi and high whtr in this population [ table 4 ] . in multiple regression analysis a model was utilized that included age , bmi , whr , whtr , wc , avi , sbp , dbp , plasma t - cho , trg , and smoking .
this revealed age , whtr , and whr as an independent determinant of most of the cad risk factors in both genders .
multiple regression analysis for whtr and whr showed that both of them were significantly associated with most of the cad risk factors , such as age  45 years , high sbp , high dbp , dm , low hdl , high ldl , high t - cho , and high trg [ table 5 ] .
relation of anthropometric variables and coronary artery disease risk factors in males and females furthermore , the whr was the single independent variable to all or most of the cad risk factors by multiple regression analysis .
multiple logistic regression analysis revealed whtr and whr were significantly associated with age ( p < 0.001 ) , bmi ( p < 0.001 ) dm ( p = 0.005 ) , sbp ( p < 0.001 ) , dbp ( p < 0.001 ) , low hdl in females , and high trg in males ( p < 0.001 ) [ figure 1 ] .
conventional cad risk factors , such as physical inactivity , central obesity , hypertension , low hdl , age  45 years , and hypertriglyceridemia were highly prevalent in males , whereas physical inactivity , central obesity , hypertension , age  45 years , and hypercholesterolemia were highly prevalent in female population .
compared to overall obesity , central obesity was better correlated with most of the cad risk factors .
whtr was better predictive of cad risk factors than wc and whr in present study .
cutoff value for whtr has not been calculated for the indian population , hence further studies are required for calculation in the indian context . in the present study ,
whtr was a powerful predictor of most of the cad risk factors , whereas whr , wc , and avi were next to it in a decreasing order .
we have compared our results with various studies in which lin et al in a general population study reported that , whtr is a better indicator for predicting cvd risk factors than the other 3 indices ( bmi , wc , and whr ) in taiwan , which is comparable with our study .
lin et al and hsieh et al also stated that whtr is a better predictor of most of the cad risk factors than whr , wc , and bmi .
huang et al in a general population study in taiwan found that the 4 anthropometric indices ( bmi , wc , whr , and whtr ) are closely related to cardiovascular risk factors , which is comparable with our study .
the results of misra et al indicated a high prevalence of diabetes , obesity , and dyslipidemia in urban slum population in northern india in middle age , particularly in females , which is comparable with our study .
guerrero - romero et al in their study of 746 men and nonpregnant women randomly recruited from durango city in northern mexico , stated that avi is reliable and shown to be strongly related to igt and dm , which is comparable with our study , but they have not correlated the association with other cad risk factors , such as hypertension , dyslipidemia , and physical inactivity . in southern andhra pradesh , india ,
a study of randomly selected urban and rural population by venkatramana et al suggested that bmi and wc are better indicators of cad risk factors , which is partially comparable with our study as other anthropometric variables have not been used in their study .
reeder et al in 5 canadian provinces ( alberta , manitoba , ontario , quebec , and saskatchewan ) general population study , found that wc was the measure of abdominal obesity most highly correlated with cardiovascular disease risk factors , which is partially comparable with our study . in omani population al - riyami and afifi , in their study among male adults aged 20 years and above in a community - based survey as a part of the national health survey , reported that current smokers were of low bmi compared with nonsmokers and exsmokers and currently light smokers were also of low bmi compared with exsmokers , which is comparable with our study .
ledoux et al , in a canadian general population study stated that the wc and bmi correlate most closely with blood pressure and plasma lipids , which is comparable with the present study .
onat et al , in a random sample of turkish general adult population , observed that the wc and whr were strongly associated with bmi and dbp and plasma trg in turkish women , which is similar to and comparable with our results .
hsieh et al , in a study found that , the whtr and whr increased with age in both the genders , which is comparable with our results .
rosmond et al , in a selected population study , reported that obesity ( bmi ) and centralization of body fat stores ( whr ) are differently associated with occupational factors as well as leisure time activities .
hu et al reported that television watching and other sedentary behaviors are related to risk of obesity and type 2 dm in women . both these studies are comparable with the current study .
slattery et al in a study of the us railroad population quoted that occupationally and leisure time physically inactive employees are at a higher risk of developing cad risk factors and cardiovascular death , which is consistent with the current study .
several studies showed that smokers have , on an average , lower bmi than nonsmokers and that smoking cessation is often associated with weight gain . in the present study
, whtr has been found to be significantly and positively associated with most of the cad risk factors , hence whtr can be used routinely as an anthropometric tool for prediction of cad risk factors in epidemiologic studies.[2529 ] the other parameters of coronary artery risk [ c - reactive protein ( crp ) , homocysteine , and others ] have not been done in the present study because of limitations of study to conventional cad risk factors and resource limitations .
other cad risk factors , such as hyperhomocysteinemia , have not shown a robust utility in chd risk stratification , and there are no clinical trial data showing that intervention to lower homocysteine levels reduces chd events .
measurement of homocysteine levels should be reserved for individuals with atherosclerosis at a young age or out of proportion to established risk factors .
elevations in acute - phase reactants , such as fibrinogen or crp , may reflect overall atherosclerotic burden or extravascular inflammation that could potentiate atherosclerosis or its complications .
crp measured by high - sensitivity assay , adds predictive information to that derived from established coronary artery risk factors , such as cholesterol .
elevated levels of the acute - phase reactant crp and fibrinogen may merely reflect ongoing inflammation rather than a direct etiologic role for crp in cad . in the present study ,
the prevalence of metabolic syndrome ( using atp iii criteria modified for indians ) was 25.17% in males and 27.35% in females .
among all the components of metabolic syndrome , high wc was most prevalent in females and systolic hypertension in males .
in the current study , the most common cad risk factor was truncal obesity in the solapur division railway employees .
generalized obesity , overweight , and central obesity problem was more prevalent in subjects with age  45 years , sedentary job , physical inactivity , and female gender .
there was a significant lack of physical activity and exercise among sedentary job workers , leading to overweight and obesity .
generalized obesity , overweight , and central obesity were significantly correlated with cad risk factors , such as age  45 years , dyslipidemia , hypertension , dm , and physical inactivity .
central obesity measured by whtr was strongly correlated with majority of cad risk factors than whr , wc , and avi .
these observations serve to underline the central role of overweight / obesity and the additive deleterious effects of abdominal obesity in the pathogenesis of lipid and carbohydrate metabolism , leading to chd and type 2 dm , and hypertension .
the present study shows a disturbing burden of coronary risk factors mainly truncal obesity , physical inactivity , hypertension in a sample population of railway employees .
there is an urgent need to undertake population - based measures to reverse the trend . out of all the anthropometric variables , whtr was significantly and positively associated with most of the cad risk factors , hence whtr can be used routinely as an anthropometric tool for prediction of cad risk factors in epidemiologic studies . by preventing obesity and overweight , a substantial part of chd mortality
may be prevented because a majority of the cad risk factors are strongly correlated with anthropometric indices .
we concluded that weight control should be an integral part of the prevention of cardiovascular disease .
 turn in obesity express highway probably lies in lifestyle modifications , going back to a traditional lifestyle with a judicious use of modern technology .
 background and objectives : anthropometric variables and their relation to conventional coronary artery disease ( cad ) risk factors in railway employees have been inadequately studied in india . 
 this cross - sectional survey was carried out in the solapur division of the central railway in the year 2004 , to assess the anthropometric variables in railway employees and their relation to conventional cad risk factors.materials and methods : a total of 995 railway employees , with 872 males and 123 females participated in this cross - sectional study . 
 all subjects underwent anthropometric measurements , fasting lipid profile , and blood sugar level . 
 various anthropometric indices were calculated for body mass index ( bmi ) , waist circumference ( wc ) , waist - to - hip ratio ( whr ) , waist - to - height ratio ( whtr ) , and abdominal volume index ( avi ) . 
 statistical analysis was done by epi info 6 statistical software.results:compared to all other obesity indices , whtr was most prevalent in both genders . 
 high whtr was present in 699 ( 80.16% ) males and 103 ( 83.73% ) females . 
 age 45 years , high systolic bp , high diastolic bp , low hdl , high triglyceride , and diabetes mellitus were positively correlated with high bmi , high wc , high whr , high whtr , and high avi . 
 high bmi , high wc , high whr , high whtr , and high avi were negatively associated with physical inactivity.conclusions:over all , anthropometric variables in both genders were significantly deranged in subjects with coronary risk factors . 
 compared to all other anthropometric variables , whtr was statistically significantly associated with a majority of coronary artery risk factors . hence we recommend inclusion of whtr as a parameter of obesity to predict coronary artery disease risk factor along with wc , whr , and bmi in epidemiologic studies . 