Detection of cardio-metabolic risk by BMI and waist circumference among a population of Guatemalan adults

Gregory, Cria O.; Ramírez‐Zea, Manuel; Martorell, Reynaldo; Stein, Aryeh D.

doi:10.1017/s1368980007001504

Cited by 5 publications

(8 citation statements)

References 33 publications

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“…Al-Lawati et al in 2008 [ 24 ], reported the optimum BMI cut-off for the Omani Arab population as 23.2 kg/m 2 and 26.8 kg/m 2 for men and women older than 20 years old, respectively. In another study [ 25 ] evaluating BMI based on metabolic risk factors conducted in Guatemala, as a developing country, they documented BMI cut-offs similar to our study as 24.7–26.1 kg/m 2 for men and 26.5–27.6 kg/m 2 for women.…”

Section: Discussionsupporting

confidence: 85%

Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study

et al. 2016

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In this study we evaluated and redefined the optimum body mass index (BMI) cut-off point for the Iranian population based on metabolic syndrome (MeS) risk factors. We further evaluated BMI cut-off points with and without waist circumference (WC) as a cofactor of risk and compared the differences. This study is part of the largest surveillance programs conducted in Shiraz, Iran, termed the Shiraz Heart study. Our study sample included subjects between the ages of 20 to 65 years old. After excluding pregnant women, those with missing data and those with comorbid disease, a total of 12283 made up the study population. The participants underwent a series of tests and evaluations by trained professionals in accordance with WHO recommendations. Hypertension, abnormal fasting blood sugar (FBS), triglyceride (TG) and high density lipoprotein cholesterol (HDL) (in the context of the definition of metabolic syndrome) were prevalent among 32.4%, 27.6%, 42.1 and 44.2% of our participants, respectively. Women displayed higher rates of overall obesity compared to men (based on the definition by the WHO as higher than 30 kg/m2). Regarding MeS, 38.9% of our population had the all symptoms of MeS which was more prevalent among women (41.5% vs. 36%). When excluding WC in the definition of MeS, results showed that males tend to show a higher rate of metabolic risk factors (19.2% vs. 15.6%). Results of multivariate analysis showed that parallel to an increase in BMI, the odds ratio (OR) for acquiring each component of the metabolic syndrome increased (OR = 1.178; CI: 1.166–1.190). By excluding WC, the previous OR decreased (OR = 1.105; CI: 1.093–1.118). Receiver Operating Characteristic (ROC) curve analysis showed that the optimum BMI cut-off point for predicting metabolic syndrome was 26.1 kg/m2 and 26.2 kg/m2 [Accuracy (Acc) = 69% and 61%, respectively)] for males and females, respectively. The overall BMI cut-off for both sexes was 26.2 kg/m2 (Acc = 65%) with sensitivity and specificity of 69% and 62%, respectively. This cut-off had a positive predictive value of 54% and a negative predictive value of 76%. When we excluded waist circumference, the optimum BMI cut-off for acquiring metabolic risk factors in males decreased to 25.7 kg/m2 (Acc = 67%) and increased for women to 27.05 kg/m2 (Acc = 66%). Iranians are at higher risks of morbidity related to metabolic factors at a lower BMI cut-off and prompt action and preventive health policy are required to prevent and educate Iranians regarding diseases associated with obesity.

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Section: Discussionsupporting

confidence: 85%

Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study

et al. 2016

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“…A study conducted in Colombian subjects with no previous CVD history, reported that the criteria for waist circumference proposed by the International Diabetes Federation (90 cm: men, 80 cm: women) is more useful for identifying subjects with MetS than that proposed by the Adult Treatment Panel III (102 cm: men, 88 cm: women) [ 22 ]. In addition, several studies [ 109 , 110 ] carried out in developing countries have reported lower waist circumference cutoff points for cardiovascular risk than those reported in developed countries. In healthy young Colombian men, a waist circumference of 88 cm identified subjects with cardiovascular risk with a sensitivity of 83.7% and a specificity of 84.8% [ 111 ].…”

Section: Abdominal Obesity Insulin Resistance and Low Degree Inflammmentioning

confidence: 97%

Maternal undernutrition and cardiometabolic disease: a latin american perspective

López‐Jaramillo

Gómez-Arbeláez

Sotomayor-Rubio

et al. 2015

BMC Med

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The current epidemic of obesity and cardiometabolic diseases in developing countries is described as being driven by socioeconomic inequalities. These populations have a greater vulnerability to cardiometabolic diseases due to the discrepancy between the maternal undernutrition and its consequence, low-birth weight progeny, and the subsequent modern lifestyles which are associated with socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Maternal undernutrition can generate epigenetic modifications, with potential long-term consequences. Throughout life, people are faced with the challenge of adapting to changes in their environment, such as excessive intake of high energy density foods and sedentary behavior. However, a mismatch between conditions experienced during fetal programming and current environmental conditions will make adaptation difficult for them, and will increase their susceptibility to obesity and cardiovascular diseases. It is important to conduct research in the Latin American context, in order to define the best strategies to prevent the epidemic of cardiometabolic diseases in the region.

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“…[37][38][39][40][41][42][43][44] Few studies have investigated the use of cut-off points in Western population, such as, in Spanish population the optimal BMI cut-off for predicting BF% were above 26 kg/m 2 in men and 24 kg/m 2 in women were associated with to 25% and 35% of BF%, respectively. 31,45,46 Already, in Mexican population showed the BMI cut-off to predict hypertension varied from 25.2 to 26.6 kg/m 2 in both men and women. 45 In accordance, our study has resulted in similar cut-off values, where showed 28 kg/m 2 in men and 26 kg/m 2 in women that corresponded to 25% and 35% of BF%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…In disagreement other studies, in Guatemalan population the optimal cut-off points for BMI were slightly higher among women (27.6 kg/m 2 ) than men (25.9 kg/m 2 ) with no meaningful differences by stature. 46 The abdominal obesity is highly correlated to insulin resistance and was also associated with an increased risk of myocardial infarction, stroke and premature death, whereas these diseases were not associated with measures of generalized obesity such as BMI. 47 In the 2001 NCEP ATP III guidelines, abdominal obesity was defined as a WC ≥102 cm in males and ≥88 cm in females.…”

Section: Discussionmentioning

confidence: 99%

“…52 This statistical method is highly recommended in epidemiological studies, but it can describe the accuracy a variable alone to classify people into relevant clinical groups. 31,[37][38][39][40][41][42][43][44][45][46]52 Therefore, we used the classification tree to discover the combination of variables (BMI and WC), and better predict a given outcome (obesity) and to identify the cutoff values for each variable that maximally predicts the chosen outcome. 23 Future researches should permeate the limitations of present study employing a larger sample and concerning associations between the amount and distribution of body fat and cardiovascular risk factors in different ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

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Optimal cut-off values for obesity using classification tree in middle-aged adults living Rio de Janeiro city

Materko

Santos

2017

Int J Res Med Sci

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Background: The goal present study was to identify cut-off points for body mass index (BMI) and waist circumference (WC) to predict values of obesity based body fat percentage (BF%) using classification tree in middle-aged adults living Rio de Janeiro city, Brazil.Methods: The data was collected in a prospective cohort composed of 886 adults (443 men and 443 women) ranging from 30 to 59 years along two years (2010 - 2011) in Rio de Janeiro City, Brazil. All subjects were submitted to anthropometric evaluation and the gold standard was the percentage of body fat estimated by bioelectrical impedance analysis. The optimal sensitivity was achieved by adjusting BMI and WC cut-off values to predict obesity based on WHO criteria: BF% >25% in men and >35% in women according to the tree classification.Results: The best cut-off for BMI and WC were 28 kg/m2 and 99 cm, respectively, with a prediction of 99.4% overall tree sensitivity in men. For women, the best cut-off for BMI and WC were 26 kg/m2 and 90 cm, respectively, with a prediction of 90.1% overall tree sensitivity.Conclusions: The BMI and WC that corresponds to a BF% previously defining obesity is similar to other Western population, but different of the recommended by WHO and NCEP to BMI and WC thresholds, respectively, for defining obesity for both genders.

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Detection of cardio-metabolic risk by BMI and waist circumference among a population of Guatemalan adults

Cited by 5 publications

References 33 publications

Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study

Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study

Maternal undernutrition and cardiometabolic disease: a latin american perspective

Optimal cut-off values for obesity using classification tree in middle-aged adults living Rio de Janeiro city

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