Is waist circumference ≥102/88cm better than body mass index ≥30 to predict hypertension and diabetes development regardless of gender, age group, and race/ethnicity? Meta-analysis

Article · January 2017with221 Reads
DOI: 10.1016/j.ypmed.2017.01.012
Abstract
Between body mass index (BMI) ≥ 30 and waist circumference (WC) ≥ 102/88 cm, we investigated which of the two measures is a better predictor of two of the most common chronic diseases – diabetes mellitus and hypertension while also examining differential association by gender, age group, and race/ethnicity. Meta-analysis was conducted for all longitudinal studies with at least 12 months of follow-up published up to April 2015. Ratio of relative risk (rRR) and relative risk of diseases were computed and compared by baseline obesity measurement. The final sample included 23 longitudinal observation studies involving 62 study arms with 259,200 individuals. WC ≥ 102/88 cm was a better predictor than BMI ≥ 30 for development of diabetes (rRR = 0.81, 95% CI = 0.68–0.96), but not for hypertension (rRR = 0.92, 95% CI = 0.80–1.06). Subgroup analyses showed WC ≥ 102/88 cm was a better predictor for diabetes in women than men, and for ages 60 and older than other ages. Only WC ≥ 102/88 cm, not BMI ≥ 30, predicted development of hypertension among Hispanic/Latinos. Neither BMI ≥ 30 nor WC ≥ 102/88 cm were significant predictors of hypertension when age group was controlled. Central obesity may be a more serious risk factor for diabetes development in women and for older ages. The predictive power of BMI ≥ 30 or WC ≥ 102/88 cm in hypertension development should not be emphasized as either could mask the effect of age.
    • Therefore, strategies aiming at preventing abdominal obesity are urgently needed to reduce the increasing burden of diabetes, CVD, and metabolic diseases. Previous studies have assessed the relationship between abdominal obesity and diabetes incidence [24][25][26][27][28][29][30]33,34]. Nevertheless, whether the long-term dynamic increase in WC leads to prediabetes is not well described.
    [Show abstract] [Hide abstract] ABSTRACT: The risk of incident prediabetes with gain in waist circumference (WC) has not been addressed among Chinese adults. A total of 7951 participants who underwent health check-ups at the Beijing Physical Examination Center and Beijing Xiaotangshan hospital were recruited in 2009 and followed up in 2016. Participants were classified into four groups according to categories of percent WC gain: ≤−2.5%, −2.5–2.5%, 2.5–5%, and >5%. The effect of WC gain on prediabetes was evaluated using modified Poisson regression models. Over seven years of follow-up, we identified 1034 prediabetes cases (413 women). Compared with a WC gain of ≤−2.5%, participants with a WC gain of >5% have a higher risk of prediabetes, be they male (non-abdominal obesity at baseline group: RR = 1.57, 95% CI: 1.10–2.24, abdominal obesity at baseline group: RR = 1.66, 95% CI: 1.20–2.30) or female (non-abdominal obesity at baseline group: RR = 1.74, 95% CI: 1.14–2.64, abdominal obesity at baseline group: RR = 2.47, 95% CI: 1.43–4.28). In conclusion, the risk of prediabetes increased significantly with increasing WC for both genders in the Chinese population. Lifestyle interventions aiming at preventing abdominal obesity are urgently needed to reduce the increasing burden of prediabetes, diabetes, and its complications.
    Full-text · Article · Oct 2017
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October 2017 · International Journal of Environmental Research and Public Health · Impact Factor: 2.06
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