Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan

Abstract

BACKGROUND:The increased health risks associated with obesity have been found to occur in Asians at lower body mass indices (BMIs). To determine the optimal cut-off values for overweight or obesity in Taiwan, we examined the relationships between four anthropometric indices and cardiovascular risk factors. METHODS: The data were collected from four health-screening centers from 1998 to 2000 in Taiwan. Included were 55 563 subjects (26 359 men and 29 204 women, mean age ¼ 37.3 AE 10.9 and 37.0 AE 11.1 y, respectively). None had known major systemic diseases or were taking medication. Individual body weight, height, waist circumference (WC), and a series of tests related to cardiovascular risk (blood pressure, fasting plasma glucose, triglycerides, total cholesterol, low-and high-density lipoprotein cholesterol) were assessed and their relationships were examined. Receiver operating characteristic (ROC) analysis was used to find out the optimal cut-off values of various anthropometric indices to predict hypertension, diabetes mellitus and dyslipidemia. RESULTS: Of the four anthropometric indices we studied, waist-to-height ratio (WHtR) in women was found to have the largest areas under the ROC curve (women ¼ 0.755, 95% CI 0.748 -0.763) relative to at least one risk factor (ie hypertension or diabetes or dyslipidemia). The optimal cut-off values for overweight or obesity from our study in men and women showed that BMIs of 23.6 and 22.1 kg=m 2 , WCs of 80.5 and 71.5 cm, waist-to-hip ratios (WHpR) of 0.85 and 0.76, and WHtR of 0.48 and 0.45, respectively, may be more appropriate in Taiwan. CONCLUSIONS: WHtR may be a better indicator for screening overweight-or obesity-related CVD risk factors than the other three indexes (BMI, WC and WHpR) in Taiwan. Our study also supported the hypothesis that the cut-off values using BMI and WC to define obesity should be much lower in Taiwan than in Western countries.

Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity

“…McNeely et al 27 reported that only 15 of 240 Japanese Americans studied prospectively met the criteria of abdominal obesity, concluding that the established guidelines for waist circumference were insensitive predictors of risk for development of type 2 diabetes mellitus in Japanese Americans. 27 Waist circumference cutoff point were defined to be 80.5 and 71.5 cm for Taiwanese 28 and X85 and X80 cm for Chinese men and women, respectively. 29 Lower waist circumference cutoff points as compared to the presently accepted values have been shown for other Asian populations as well: Japanese 30 and Malays.…”

Obesity indices and cardiovascular risk factors in Thai adults

“…3,4,22,23 However, the optimal cutoff point for waist circumference for Thai compared to other Asian countries such as Chinese or Japanese might be different. 24,25 The variation might be due to the difference in age group, the body size, metabolic status and physical activity. The present study has confirmed that WC was comparable to WHpR and WHtR in association with cardiovascular risk factors, although some studies have shown WC is better associated with cardiovascular risk factors and outcome when compared to WHpR 3,26-28 and some studies advocate WHtR as a better indicator.…”

Trends in the association between blood pressure and obesity in a Taiwanese population between 1996 and 2006

“…7,8 With the continuing increases in general well-being and standard of living, it is expected that the problem of obesity will further increase. 9 Although obesity has been shown to be associated with an increased risk of cardiovascular diseases and diabetes, [10][11][12][13] it is not yet clear whether the increased prevalence of obesity in the Taiwanese population in the last 30 years is reflected by increased risk of chronic disease. Because of rapid economic and population growth, the living environment (for example affordability and availability of food, transportation, housing) has been transformed dramatically, and the mismatch between foetal programming and the subsequent environment may therefore cause health problems in later life.…”