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

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          Abstract

          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 (R 2 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 (R 2 = 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.

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          Waist circumference and not body mass index explains obesity-related health risk.

          Ian Janssen, Peter Katzmarzyk, Robert Ross (2004)
          The addition of waist circumference (WC) to body mass index (BMI; in kg/m(2)) predicts a greater variance in health risk than does BMI alone; however, whether the reverse is true is not known. We evaluated whether BMI adds to the predictive power of WC in assessing obesity-related comorbidity. Subjects were 14 924 adult participants in the third National Health and Nutrition Examination Survey, grouped into categories of BMI and WC in accordance with the National Institutes of Health cutoffs. Odds ratios for hypertension, dyslipidemia, and the metabolic syndrome were compared for overweight and class I obese BMI categories and the normal-weight category before and after adjustment for WC. BMI and WC were also included in the same regression model as continuous variables for prediction of the metabolic disorders. With few exceptions, overweight and obese subjects were more likely to have hypertension, dyslipidemia, and the metabolic syndrome than were normal-weight subjects. After adjustment for WC category (normal or high), the odds of comorbidity, although attenuated, remained higher in overweight and obese subjects than in normal-weight subjects. However, after adjustment for WC as a continuous variable, the likelihood of hypertension, dyslipidemia, and the metabolic syndrome was similar in all groups. When WC and BMI were used as continuous variables in the same regression model, WC alone was a significant predictor of comorbidity. WC, and not BMI, explains obesity-related health risk. Thus, for a given WC value, overweight and obese persons and normal-weight persons have comparable health risks. However, when WC is dichotomized as normal or high, BMI remains a significant predictor of health risk.
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            Abdominal adiposity and coronary heart disease in women.

            Kathryn Rexrode (1998)
            Obesity is a well-established risk factor for coronary heart disease (CHD), but whether regional fat distribution contributes independently to risk remains unclear. To compare waist-hip ratio (WHR) and waist circumference in determining risk of CHD in women. Prospective cohort study among US female registered nurses participating in the Nurses' Health Study conducted between 1986, when the nurses completed a questionnaire, and follow-up in June 1994. A total of 44702 women aged 40 to 65 years who provided waist and hip circumferences and were free of prior CHD, stroke, or cancer in 1986. Incidence of CHD (nonfatal myocardial infarction or CHD death). During 8 years of follow-up 320 CHD events (251 myocardial infarctions and 69 CHD deaths) were documented. Higher WHR and greater waist circumference were independently associated with a significantly increased age-adjusted risk of CHD. After adjusting for body mass index (BMI) (defined as weight in kilograms divided by the square of height in meters) and other cardiac risk factors, women with a WHR of 0.88 or higher had a relative risk (RR) of 3.25 (95% confidence interval [CI], 1.78-5.95) for CHD compared with women with a WHR of less than 0.72. A waist circumference of 96.5 cm (38 in) or more was associated with an RR of 3.06 (95% CI, 1.54-6.10). The WHR and waist circumference were independently strongly associated with increased risk of CHD also among women with a BMI of 25 kg/m2 or less. After adjustment for reported hypertension, diabetes, and high cholesterol level, a WHR of 0.76 or higher or waist circumference of 76.2 cm (30 in) or more was associated with more than a 2-fold higher risk of CHD. The WHR and waist circumference are independently associated with risk of CHD in women.
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              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 : Adiposity & mortality

              S Czernichow, A-P Kengne, E. Stamatakis … (2011)
              Few studies have examined both the relative magnitude of association and the discriminative capability of multiple indicators of obesity with cardiovascular disease (CVD) mortality risk. We conducted an individual-participant meta-analysis of nine cohort studies of men and women drawn from the British general population resulting in sample of 82 864 individuals. Body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were measured directly. There were 6641 deaths (1998 CVD) during a mean of 8.1 years of follow-up. After adjustment, a one SD higher in WHR and WC was related to a higher risk of CVD mortality (hazard ratio [95% CI]): 1.15 (1.05-1.25) and 1.15 (1.04-1.27), respectively. The risk of CVD mortality also increased linearly across quintiles of both these abdominal obesity markers with a 66% increased risk in the highest quintile of WHR. In age- and sex-adjusted models only, BMI was related to CVD mortality but not in any other analyses. No major differences were revealed in the discrimination capabilities of models with BMI, WC or WHR for cardiovascular or total mortality outcomes. In conclusion, measures of abdominal adiposity, but not BMI, were related to an increased risk of CVD mortality. No difference was observed in discrimination capacities between adiposity markers. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2458
                Publication date Collection: 2012
                Publication date (Electronic): 10 August 2012
                Volume: 12
                Page: 638
                Affiliations
                [1 ]PhD Programme of Public Health, Faculty of Medicine, University of Chile, Independencia, 1027, Santiago, Chile
                [2 ]Department of Nutrition, Faculty of Medicine, University of Chile, Independencia, 1027, Santiago, Chile
                [3 ]School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
                [4 ]Department of Psychological Medicine, King’s College, London, UK
                Article
                Publisher ID: 1471-2458-12-638
                DOI: 10.1186/1471-2458-12-638
                PMC ID: 3441472
                PubMed ID: 22882972
                SO-VID: 65af5ded-635a-4dde-8f66-cc744de31423
                Copyright © Copyright ©2012 Lara et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 24 January 2012
                Date accepted : 26 July 2012
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Public health
                Keywords: cardiovascular risk factors,body mass index,young adults,waist circumference
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: cardiovascular risk factors, body mass index, young adults, waist circumference

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