Comparison of body mass index, waist circumference, and waist to height ratio in the prediction of hypertension and diabetes mellitus: Filipino-American women cardiovascular study

Abstract

The relative ability of three obesity indices to predict hypertension (HTN) and diabetes (DM) and the validity of using Asian-specific thresholds of these indices were examined in Filipino-American women (FAW). Filipino-American women (n = 382), 40–65 years of age were screened for hypertension (HTN) and diabetes (DM) in four major US cities. Body mass index (BMI), waist circumference (WC) and waist circumference to height ratio (WHtR) were measured. ROC analyses determined that the three obesity measurements were similar in predicting HTN and DM (AUC: 0.6–0.7). The universal WC threshold of ≥ 35 in. missed 13% of the hypertensive patients and 12% of the diabetic patients. The Asian WC threshold of ≥ 31.5 in. increased detection of HTN and DM but with a high rate of false positives. The traditional BMI ≥ 25 kg/m2 threshold missed 35% of those with hypertension and 24% of those with diabetes. The Asian BMI threshold improved detection but resulted in a high rate of false positives. The suggested WHtR cut-off of ≥ 0.5 missed only 1% of those with HTN and 0% of those with DM. The three obesity measurements had similar but modest ability to predict HTN and DM in FAW. Using Asian-specific thresholds increased accuracy but with a high rate of false positives. Whether FAW, especially at older ages, should be encouraged to reach these lower thresholds needs further investigation because of the high false positive rates.

Preditores antropométricos de hipertensão arterial sistêmica em mulheres afrodescendentes

“…Battie et al [8] ao avaliarem a capacidade de IMC, CC e RCE em predizer a HAS em mulheres filipinoamericanas também encontraram que essas medidas tiveram baixo poder discriminatório (AUC 0,60-0,70), sendo que esses parâmetros apresentaram igual capacidade em predizer a HAS.…”

“…Diversos trabalhos têm utilizado as curvas ROC procurando identificar os melhores pontos de corte de diferentes parâmetros antropométricos para a predição da HAS em diferentes populações [8][9][10][33][34][35], em virtude da magnitude dessa doença e de que os pontos de corte propostos pela OMS foram estabelecidos para caucasianos [14]. Nesse sentido, destaca-se que o presente estudo foi o primeiro que visou identificar o melhor preditor antropométrico de HAS em mulheres de comunidades remanescentes de quilombos.…”

“…Desse modo, devido à associação da quantidade e, sobretudo, da distribuição da GC com a HAS, parâ-metros antropométricos têm sido investigados como preditores de HAS em diferentes populações [8][9][10]. Contudo, há divergências quanto à sua acurácia para distinguir pessoas com HAS, possivelmente em decorrência de que a identificação de riscos à saúde pode ser afetada pela altura e outras condições, incluindo características raciais/étnicas [9].…”

Association between sitting time and obesity: A population‐based study in Peru

“…There are several ways to evaluate obesity, such as body mass index (BMI), waist circumference (WC) and waist to height ratio (WHR), among others. The BMI indicates general obesity, depending only on weight and height, and ignoring variations in the physical characteristics of the person or difference between lean mass and fat mass . On the other hand, WC and WHR indicate central obesity and fat mass.…”

“…The BMI indicates general obesity, depending only on weight and height, and ignoring variations in the physical characteristics of the person or difference between lean mass and fat mass. 7,8 On the other hand, WC and WHR indicate central obesity and fat mass. In addition, WHR has been considered as a more appropriate indicator in low-size populations, such as the Peruvian population.…”