Is waist circumference a better predictor of blood pressure, insulin resistance and blood lipids than body mass index in young Chilean adults?

BMC Public Health

Roberto J Rona³  Claudio Silva¹  Hugo Amigo⁴  Patricia Bustos⁴  Macarena Lara² 

[1] School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile;PhD Programme of Public Health, Faculty of Medicine, University of Chile, Independencia, 1027, Santiago, Chile;Department of Psychological Medicine, King’s College, London, UK;Department of Nutrition, Faculty of Medicine, University of Chile, Independencia, 1027, Santiago, Chile

关键词: young adults;    cardiovascular risk factors;    body mass index;    Waist circumference;   

Others  :  1163315
DOI  :  10.1186/1471-2458-12-638

 received in 2012-01-24, accepted in 2012-07-26,  发布年份 2012

【 摘 要 】

Background

It has been reported that waist circumference (WC) is a better predictor of cardiovascular risk factors than body mass index (BMI), although the findings have not been consistent. The aim of this study was to assess which measurement, BMI or WC, is more strongly associated with blood pressure, homeostatic model assessment (HOMA) and blood lipids in young Chilean adults.

Methods

999 subjects aged 22 to 28 years were randomly selected from a registry of individuals born between 1974 and 1978 at the Hospital of Limache, Chile. Weight, height, WC, blood pressure, HOMA and lipoproteins were assessed in a cross-sectional study.

Results

In multivariable regressions BMI and WC were associated with blood pressure, HOMA and lipoproteins at similar level of explained variation (R² between 1.6 % for Low Density Lipoproteins (LDL) and 15.6 %, the highest for HOMA and triglycerides) and similarly OR in standardised logistic regressions between 1.1 (95 % CI: 0.9 and 1.4) for LDL and 2.9 (95 % CI: 2.4 and 3.4) for elevated HOMA. When both WC and BMI were included in the model collinearity was high and only for HOMA was there a small independent contribution of each index (R² = 1 %); for other outcomes the pattern was inconsistent.

Conclusion

The strength of the associations of WC and BMI for any cardiovascular risk factors was similar, but highest for HOMA and triglycerides. WC and BMI are equally useful for monitoring the consequences of obesity in young adults.

【 授权许可】

   
2012 Lara et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]World Health Organization: Obesity: preventing and managing the global epidemic. http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/index.html webcite
• [2]Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J: Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk–a review of the literature. Eur J Clin Nutr 2010, 64(1):16-22.
• [3]Ho SY, Lam TH, Janus ED: Waist to stature ratio is more strongly associated with cardiovascular risk factors than other simple anthropometric indices. Ann Epidemiol 2003, 13(10):683-691.
• [4]Lee CM, Huxley RR, Wildman RP, Woodward M: Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol 2008, 61(7):646-653.
• [5]Menke A, Muntner P, Wildman RP, Reynolds K, He J: Measures of adiposity and cardiovascular disease risk factors. Obesity (Silver Spring) 2007, 15(3):785-795.
• [6]Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004, 79(3):379-384.
• [7]Zhu S, Wang Z, Heshka S, Heo M, Faith MS, Heymsfield SB: Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr 2002, 76(4):743-749.
• [8]Chan DC, Barrett HP, Watts GF: Dyslipidemia in visceral obesity: mechanisms, implications, and therapy. Am J Cardiovasc Drugs 2004, 4(4):227-246.
• [9]Vazquez G, Duval S, Jacobs DR: Silventoinen K: Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev 2007, 29:115-128.
• [10]Huxley R, James WP, Barzi F, Patel JV, Lear SA, Suriyawongpaisal P, Janus E, Caterson I, Zimmet P, Prabhakaran D, et al.: Ethnic comparisons of the cross-sectional relationships between measures of body size with diabetes and hypertension. Obes Rev 2008, 9(Suppl 1):53-61.
• [11]Nyamdorj R, Qiao Q, Lam TH, Tuomilehto J, Ho SY, Pitkaniemi J, Nakagami T, Mohan V, Janus ED, Ferreira SR: BMI compared with central obesity indicators in relation to diabetes and hypertension in Asians. Obesity (Silver Spring) 2008, 16(7):1622-1635.
• [12]Barzi F, Woodward M, Czernichow S, Lee CM, Kang JH, Janus E, Lear S, Patel A, Caterson I, Patel J, et al.: The discrimination of dyslipidaemia using anthropometric measures in ethnically diverse populations of the Asia-Pacific Region: the Obesity in Asia Collaboration. Obes Rev 2010, 11(2):127-136.
• [13]Kelly T, Yang W, Chen CS, Reynolds K, He J: Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008, 32(9):1431-1437.
• [14]Low S, Chin MC, Deurenberg-Yap M: Review on epidemic of obesity. Ann Acad Med Singapore 2009, 38(1):57-59.
• [15]Liu Y, Tong G, Tong W, Lu L, Qin X: Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects? BMC Public Health 2011, 11:35.
• [16]Rona RJ, Smeeton NC, Bustos P, Amigo H, Diaz PV: The early origins hypothesis with an emphasis on growth rate in the first year of life and asthma: a prospective study in Chile. Thorax 2005, 60(7):549-554.
• [17]Wu AH, Contois JH, Cole TG: Reflex testing I: algorithm for lipid and lipoprotein measurement in coronary heart disease risk assessment. Clin Chim Acta 1999, 280(1–2):181-193.
• [18]Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28(7):412-419.
• [19]Acosta AM, Escalona M, Maiz A, Pollak F, Leighton F: Determination of the insulin resistance index by the Homeostasis Model Assessment in a population of Metropolitan Region in Chile. Rev Med Chil 2002, 130(11):1227-1231.
• [20]Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, et al.: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003, 289(19):2560-2572.
• [21]Expert Panel on Detection E: and Treatment of High Blood Cholesterol in Adults,: Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001, 285(19):2486-2497.
• [22]Seidell JC, Cigolini M, Deslypere JP, Charzewska J, Ellsinger BM, Cruz A: Body fat distribution in relation to serum lipids and blood pressure in 38-year-old European men: the European fat distribution study. Atherosclerosis 1991, 86(2–3):251-260.
• [23]Farin HM, Abbasi F, Reaven GM: Body mass index and waist circumference both contribute to differences in insulin-mediated glucose disposal in nondiabetic adults. Am J Clin Nutr 2006, 83(1):47-51.
• [24]Kiernan M, Winkleby MA: Identifying patients for weight-loss treatment: an empirical evaluation of the NHLBI obesity education initiative expert panel treatment recommendations. Arch Intern Med 2000, 160(14):2169-2176.
• [25]Zhu S, Heshka S, Wang Z, Shen W, Allison DB, Ross R, Heymsfield SB: Combination of BMI and Waist Circumference for Identifying Cardiovascular Risk Factors in Whites. Obes Res 2004, 12(4):633-645.
• [26]Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE: Abdominal adiposity and coronary heart disease in women. JAMA 1998, 280(21):1843-1848.
• [27]Folsom AR, Stevens J, Schreiner PJ, McGovern PG: Body mass index, waist/hip ratio, and coronary heart disease incidence in African Americans and whites. Atherosclerosis Risk in Communities Study Investigators. Am J Epidemiol 1998, 148(12):1187-1194.
• [28]Czernichow S, Kengne AP, Stamatakis E, Hamer M, Batty GD: Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk?: evidence from an individual-participant meta-analysis of 82 864 participants from nine cohort studies. Obes Rev 2011, 12(9):680-687.
• [29]Esmaillzadeh A, Mirmiran P, Azizi F: Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men. Int J Obes Relat Metab Disord 2004, 28(10):1325-1332.
• [30]Esmaillzadeh A, Mirmiran P, Azizi F: Comparative evaluation of anthropometric measures to predict cardiovascular risk factors in Tehranian adult women. Public Health Nutr 2006, 9(1):61-69.
• [31]Garg A: Regional adiposity and insulin resistance. J Clin Endocrinol Metab 2004, 89(9):4206-4210.
• [32]Lebovitz HE, Banerji MA: Point: visceral adiposity is causally related to insulin resistance. Diabetes Care 2005, 28(9):2322-2325.
• [33]DeFronzo RA: Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidaemia and atherosclerosis. Neth J Med 1997, 50(5):191-197.