Efficiency of anthropometric indicators of Obesity for identifying cardiovascular risk factors in a Chinese population

Department of Endocrinology, Qilu Hospital, Shandong University, Jinan, Shandong, China.
Postgraduate medical journal (Impact Factor: 1.45). 03/2011; 87(1026):251-6. DOI: 10.1136/pgmj.2010.100453
Source: PubMed


To evaluate the predictive value of the body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) for the presence of several cardiovascular risk conditions-hypertension, dyslipidaemia, metabolic syndrome (MS), and type 2 diabetes-in a Chinese population in Jinan, China.
Data for a representative, cross-sectional sample of 3006 adults (mean age; range 20-74 years) in Jinan from 2007 to 2008 were studied. The association of BMI, WC, and WHtR with cardiovascular risk conditions was assessed by use of receiver operating characteristic curve (ROC) analysis and by calculating the area under the ROC (AUC) and age adjusted odds ratios (ORs) for metabolic syndrome, dyslipidaemia, type 2 diabetes, and hypertension.
AUC cut-off values showed that the association of WHtR and WC was higher than that for BMI for all risk conditions for both sexes, except for hypertension in men. The AUC values for WC showed a higher association with hypertension and metabolic syndrome for women than men (p<0.01 for hypertension, p<0.05 for metabolic syndrome). The ORs were highest for WHtR for metabolic syndrome, diabetes, and hypertension in women. The ORs were highest for BMI for hypertension in men.
Compared with BMI, measures of central obesity, particularly WHtR, show a better association with obesity related cardiovascular risk conditions for both sexes, except for hypertension in men, in Jinan, China.

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    • "Both the odds ratios (ORs) and AUC values for BMI, WC, WHR and WHtR were higher for women than for men for diabetes. Our findings related to AUC were similar to the recent meta-analysis conducted by Lee et al. [15] and Dong et al. [28]. "
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    ABSTRACT: Background Obesity is a risk factor for type 2 diabetes (DM); however, no study has specially assessed the anthropometric indices as predictors of diabetes in rural Bangladeshi population. Objective To identify markers for diabetes through body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and waist height ratio (WHtR) and identify the optimal cut-off values suitable for Bangladeshi adult population. Methods A total of 2293 subjects aged ≥20 years from rural Bangladesh were randomly recruited to participate in a population-based, cross sectional survey. Age adjusted data for anthropometric indices and diabetes risk were assessed and their relationships were examined. Results Age adjusted prevalence of DM in men and women were 9.5% and 7.0%, respectively. Both men and women with DM had a higher rate of general obesity (defined by BMI) and central obesity (defined by WC, WHR and WHtR) than non-diabetic subjects. In both men and women the most sensitive indice was WHR for predicting DM. The appropriate cut-offs values for WHR to predict DM in men and women were 0.93 and 0.87, respectively. WC of 82 cm for both sexes was appropriate to predict DM. Those of BMI and WHtR were 21.2 kg/m2, 21.8 kg/m2 and 0.53, 0.54 in men and women, respectively. Conclusions Compared with BMI, measures of central obesity, WHR, WC, WHtR showed a better association with the risk of DM for both sexes in rural Bangladeshi population. Follow-up studies are needed for validifying these cut-offs values.
    Full-text · Article · May 2014 · Obesity Research & Clinical Practice
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    • "Another study which was done by Shao et al. indicated that WHtR might be an optimal anthropometric predictor of MetS risk factors and the cut-off point of WHtR was approximately 0.50 in both genders of Chinese adults [20]. Likewise, another report by Dong et al. suggested that WHtR has better association with obesity related cardiovascular risk conditions in both sexes, except for hypertension in Chinese men [21]. An Iranian longitudinal study confirmed the cut-off points for women but decreased them to 90 cm for men. "
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    ABSTRACT: Aim. This study aimed to investigate which anthropometric indices could be a better predictor of metabolic syndrome (MetS) and the cut-off points for these surrogates to appropriately differentiate MetS in the Iranian elderly. Method. The present cross-sectional study was conducted on a sample of Isfahan Healthy Heart Program (IHHP). MetS was defined according to Third Adult Treatment Panel (ATPIII). In total, 206 elderly subjects with MetS criteria were selected. Anthropometric indices were measured and plotted using receiver operating characteristic (ROC) curves. Results. WC followed by WHtR yielded the highest area under the curve (AUC) (0.683; 95% CI 0.606–0.761 and 0.680; 95% CI 0.602–0.758, resp.) for MetS. WC at a cut of 94.5 cm resulted in the highest Youden index with sensitivity 64% and 68% specificity to predict the presence of ≥2 metabolic risk factors. BMI had the lowest sensitivity and specificity for MetS and MetS components. WC has the best ability to detect MetS which followed by WHtR and BMI had a lower discriminating value comparatively. Conclusion. WC is the best predictor for predicting the presence of ≥2 metabolic risk factors among Iranian elderly population and the best value of WC is 94.5 cm. This cut-off values of WC should be advocated and used in Iranian men until larger cross-sectional studies show different results.
    Full-text · Article · Mar 2014 · Journal of obesity
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    • "But studies have shown that WHtR was strongly associated with visceral adipose tissue[43] and recently Ashwell et al.[27] in robust reviews reported that WHtR should be considered as a screening tool for cardiomatabolic risk factor in male and female because it was shown to be better than others (BMI and WC). This was supported by other studies in different parts of the world,[444546] though Guasch-Ferrι et al.[47] reported no significant differences between the predictive abilities of WHtR and WC on metabolic disease. Therefore, WHtR could be the most useful anthropometric variable for predicting MetS and CVD risk factor in a population because it is not dependent on age or sex and it is easy to use.[41] "
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    ABSTRACT: Background: Ratio of second and fourth digit (2D:4D) is known to be germane in analyzing utero concentrations of testosterone and estrogen in human and other vertebrates. 2D:4D had been linked to several traits like athletes’ abilities, reproductive success, risk of cancer and cardiovascular disease (CVD). Metabolic syndrome (MetS) is a clustering of several cardiovascular risk factors. Waist circumference (WC), neck circumference (NC), body mass index (BMI) and waist-to-height ratio (WHtR) are important in measuring MetS. This study investigated sexual dimorphism in 2D:4D and its relationship with MetS indices and CVD factors among adult residing in Ilorin, North central Nigeria. Materials and Methods: This is a cross-sectional, stratified multi-staged sampling study. Participants residing in different neighborhoods were visited at home where finger lengths and anthropometric traits were measured. Participants include 801 healthy adults aged 18-44 years (56% male) who had been living in the area for more than 3 years. Results: Males showed significantly lower 2D:4D than females (unpaired t-test; t [699] = 11.49, P = 0.001). A significant positive correlation was observed in MetS markers and 2D:4D. WHtR showed the highest correlation with 2D:4D in male (r = 0.461, P ≤ 0.001) and female (r = 0.408, P ≤ 0.001) when compared with BMI, NC and WC. All positive correlations recorded in this study were high in male and right hand. Conclusion: Our results showed that 2D:4D is sexual dimorphic and right hand 2D:4D as a predictor of MetS is better. We concluded that 2D:4D is a proxy for MetS and CVD risk factors in Ilorin.
    Full-text · Article · Mar 2014 · Journal of research in medical sciences
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