Waist circumference as a determinant of hypertension and diabetes in Brazilian women: a population-based study

Abstract

Objective: To evaluate the role of central adiposity, as evaluated by the measurement of waist circumference (WC), as an independent risk factor for hypertension and type 2 diabetes mellitus in the setting of a developing country. Design: Population-based, cross-sectional study. Setting: A medium-sized town in southern Brazil. Participants: One thousand and ninety-five non-pregnant women, 20 to 69 years old, recruited by cluster random sampling between 1999 and 2000. Their mean WC was 85.3 cm (standard deviation 13.9 cm) and 23.3% (n ¼ 255) were obese (body mass index .30 kg m 22). The prevalence of hypertension and diabetes was 25.6% (n ¼ 280) and 6.2% (n ¼ 68), respectively. Results: The risks of hypertension and diabetes were directly related to WC measurement. Women with WC . 80 cm had increased risk of hypertension (odds ratio (OR) ¼ 6.2, P , 0.001). The association remained significant (OR ¼ 1.04 per cm increase in WC, P ¼ 0.02) after adjusting for confounders. The effect of WC on diabetes was modified by age. The effect was stronger in women younger than 40 years old (OR ¼ 12.7, P ¼ 0.016) than in those over 40 years old (OR ¼ 2.8, P ¼ 0.013). In the multivariate analysis, the odds ratio was 5.7 (P ¼ 0.12) in those under 40 years old and 2.8 (P ¼ 0.008) in older women. Conclusions: Waist circumference is an independent determinant for hypertension and diabetes in women in this population. The stronger association between WC and diabetes in younger women suggests that the validity of this indicator to assess abdominal adiposity is age-specific. Further studies should validate the usefulness of WC measurement in different age groups.

Acurácia da circunferência da cintura e da relação cintura/quadril como preditores de dislipidemias em estudo transversal de doadores de sangue de Cuiabá, Mato Grosso, Brasil

“…No Brasil, poucas investigações avaliaram a associação entre indicadores antropométricos de localização de gordura e desfechos que se relacionam às doenças cardiovasculares 19,20,21,22,23 . Dentre esses estudos, apenas um 21 avaliou o melhor ponto de corte para a relação cintura/quadril em relação à hipertensão arterial, encontrando o valor 0,95 para homens, portanto, abaixo daquele preconizado pela OMS e pró-ximo ao observado no nosso estudo, o que confirma a inadequação do uso de pontos de corte definidos para populações caucasianas quando se trata de avaliar a população brasileira.…”

Insatisfação corporal em escolares de uma cidade do Sul do Brasil

“…Fear to gain weight and persistent desire to lose weight can initiate an excessive concern with food, and consequently, an alteration of eating behaviors, with dietetic restrictions, joint with physical activity planned to reduce weight 33 .…”

Risco nutricional na população urbana de Ouro Preto, sudeste do Brasil: estudo de corações de Ouro Preto

“…Despite the lack of national data in Brazil on the prevalence of central overweight and central obesity, its epidemiological relevance has been increasingly demonstrated for the analysis of the nutritional risk for non-transmissible diseases because of its good correlation with visceral fat deposits 10,11,28 . Based on our current understanding of visceral triglyceride deposit metabolism 29 , both indicators have proved to be adequate predictors of metabolic complications.…”

“…However, this index has clear limitations when it comes to defining overweight/obesity according to the different categories of gender, age, race, and physical activity, and evaluating the nutritional risk for comorbidity 3,6,7 , as well as differentiating and quantifying body fat distribution 5,8 . Diabetes, arterial hypertension, and metabolic syndrome are risks known to be associated with the distribution of body fat and, more specifically, the increase of central fat 2,3,9,10 . The most commonly used method to evaluate central obesity has been the waist circumference (WC) measurement due to its good correlation with visceral fat 3,11,12 .…”