Objective: This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults.

Methods: A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist‑to‑height ratio (WHtR), waist‑to‑hip ratio (WHR), conicity index, hip circumference (HC), waist‑to‑hip‑to‑height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out‑of‑range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model.

Results: The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high‑density lipoprotein cholesterol (HDL‑C) and high low‑density lipoprotein cholesterol (LDL‑C) was found in an increase in the WHR and ABSI, respectively.

Conclusion: Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL‑C/HDL‑C ratio.