成人肥胖与高血糖高血压血脂紊乱聚集的关系

目的探讨成人肥胖与与高血糖、高血压、血脂紊乱聚集的关系。方法采用分层整群随机抽样方法,随机调查杭州市城乡社区居民20～79岁1600人。应用logistic回归模型分析肥胖的两个主要指标体质指数(BMI)和腰围对发生高血糖、高血压、血脂紊乱聚集的OR值。结果调整年龄、吸烟史、饮酒史、体育锻炼等影响因素后,男性超重(24kg/m2≤BMI28kg/m2)和肥胖(BMI≥28kg/m2)均比正常体重更易引起聚集发生,OR值分别为3.187(95%CI:1.731～5.869)和3.050(95%CI:1.248～7.453);女性中心性肥胖(腰围≥80cm)对聚集发生的OR值为2.330(95%CI:1.440～3.771)。结论成人发生高血糖、高血压、血脂紊乱聚集与肥胖存在一定关联,男性体质指数和女性腰围对心血管病的一级预防具有重要意义。     

不同类型肥胖与心血管疾病危险因素关联的比较

目的 比较不同类型肥胖与心血管疾病(CVD)危险因素的关联,为预防和控制心血管疾病提供科学依据.方法 利用"2002年中国居民营养与健康状况调查"资料,按照<中国成人超重和肥胖症预防控制指南>中判定肥胖的界值点[体重指数(BMI):24kg/m2和28 kg/m2;腰围:男性85 cm和95 cm,女性80 cm和90 cm]判定肥胖类型,比较不同类型肥胖人群与罹患CVD危险因素的关联;用logistic回归和多元线性回归分析BMI和腰围与CVD危险因素的关系.结果 与体重和腰围均在正常范围的人群(OR=1)相比,正常体重并高腰围Ⅰ(男性85～95 cm,女性80～90 cm)的人群、超重但腰围正常的人群罹患CVD危险因素的风险为1～2倍,超重并高腰围Ⅰ、肥胖但腰围正常的人群为2～3倍,超重并高腰围Ⅱ(男性≥95 cm,女性≥90 cm)、肥胖并高腰围Ⅰ或Ⅱ(男性≥85 cm,女性≥80 cm)的人群为≥3倍;同一腰围组中,随着BMI增加罹患CVD危险因素的风险也呈逐渐增加趋势;BMI和腰围同时解释CVD危险因素变异的1.7%～9.4%,大于BMI或腰围单独解释的比例(1.5%～9.0%);BMI对于收缩压的标化回归系数为0.129,略大于腰围(0.123),腰围对甘油三酯、总胆固醇和高密度脂蛋白胆同醇标化回归系数的绝对值大于BMI.结论 BMI和腰围与CVD危险因素独立相关,建议评估疾病危险时同时使用BMI和腰围两项指标.     

老年人高血压风险预测肥胖指标筛选

目的评价肥胖指标与高血压的关联性,筛选预测老年人高血压风险的良好肥胖指标。方法分析辽宁省国民体质监测点1 608名60～69岁老年人的数据资料。传统肥胖指标包括体质指数(BMI)、体格指数(PI)、腰围(WC)、腰臀比(WHR)和锥削度指数(CI);新肥胖指标包括腰围身高比(WHtR)、身体形态指数(ABSI)、身体圆润指数(BRI)、腰臀脂肪指数(AVI)、臀围指数(HI)和身体脂肪指数(BAI)。应用受试者工作特征(ROC)曲线比较不同肥胖指标预测高血压的效果,采用logistic回归分析评价肥胖指标与高血压风险的关联强度。结果辽宁省60～69岁老年人高血压率为38.6%(620/1 608),男性为41.5%(323/778),女性为35.8%(297/830)。男、女性BMI、WC、WHtR、AVI、PI、BRI、BAI预测高血压的ROC曲线下面积均有统计学意义,最佳切点值为:BMI(男:25.4 kg/m~2,女:25.6 kg/m~2),WC(男:83.5 cm,女:86.6 cm),WHtR(男:0.50,女:0.53),AVI(男:14.3 cm~2,女:15.2 cm~2),PI(男:14.6 kg/m3,女:16.1 kg/m~3),BRI(男:3.4,女:4.1)和BAI(男:25.4,女:32.6)。多元logistic回归分析表明,BMI和WHtR是预测男、女性高血压风险的良好肥胖指标;男性BMI≥25.4 kg/m~2者高血压风险是BMI 25.4 kg/m~2者的1.53倍,WHtR≥0.50者高血压风险是WHtR 0.50者的1.55倍;女性BMI≥25.6 kg/m~2者高血压风险是BMI 25.6 kg/m~2者的1.62倍,WHtR≥0.53者高血压风险是WHtR 0.53者的1.81倍。将BMI与WHtR结合,男性BMI≥25.4 kg/m~2且WHtR≥0.50者高血压风险是BMI 25.4 kg/m~2且WHtR 0.50者的2.33倍(95%CI=1.63～3.34);女性BMI≥25.6 kg/m~2且WHtR≥0.53者高血压风险是BMI 25.6 kg/m~2且WHtR 0.53者的2.88倍(95%CI=2.03～4.09)。结论 BMI和WHtR是预测老年人高血压风险的良好肥胖指标;BMI与WHtR联合应用,能够显著提高预测高血压风险的效果。     

肥胖对高血压、高血糖的预测作用分析

目的探讨体质指数、腰围及腰臀比对高血压、高血糖的预测作用。方法采用分层整群抽样法调查20岁以上,在深圳居住5年及以上8 207名常住社区居民高血压、糖尿病患病与肥胖相关数据,进行偏相关分析、交互作用分析,并在体质指数、腰围及腰臀比各切点上进行相对危险度、归因危险比、人群归因危险比分析。结果按性别分层,控制年龄进行相关分析显示血压、血糖与BMI、WC、臀围、WHR呈正相关(P(0.0001)。交互作用分析提示,BMI与WC、BMI与WHR 对高血压、高血糖、二者聚集有交互作用。BMI、WC取不同切点,各自对高血压、高血糖及二者聚集的人群危险度及归因比分析提示,BMI切点在25及以上者约占23%,控制此切点,可改善总人群 34%的高血压,23%的高血糖,44%的危险因素聚集。而男性WC切点在85cm及以上,女性WC切点在 80cm及以上者占总人群的29%,控制此因素可改善总人群45%的高血压,33%的高血糖,59%的危险因素聚集。结论结合分析偏相关系数,高血压、糖尿病的危险度,及人群预防的公共卫生意义,筛选深圳市该类疾病高危人群适当的界点是:高血压取BMI≥25cm,高血糖取男性WC≥85cm, 女性WC≥80c...     

中国成年人代谢异常相关的体质指数和腰围切点研究

目的 研究中国成年人BMI和腰围与各项代谢危险因素之间的相关性,确定超重肥胖的适宜BMI和腰围切点。方法 中国慢性病前瞻性研究于2004-2008年进行基线调查,并于2013-2014年随机抽取了5%的研究对象进行第2次重复调查。本研究剔除体格指标或代谢危险因素变量缺失或极端值、自报患有恶性肿瘤者,基线纳入501 201人,第2次重复调查纳入19 201人。比较不同BMI和腰围下代谢危险因素异常率,通过受试者工作特征（ROC）曲线分析,确定预测高血压、糖尿病、血脂异常和危险因素聚集的适宜BMI和腰围切点。结果 随BMI或腰围的增加,高血压、糖尿病、血脂异常和危险因素聚集患病率均呈现上升的趋势。依据正确指数最大的原则选取BMI超重切点和腰围切点,男性和女性BMI超重切点均接近24.0 kg/m²,男性腰围切点接近85 cm,女性腰围切点约为80~85 cm。男性和女性中,检出各项代谢危险因素特异度达到90%的BMI切点范围为27.0~28.9 kg/m²,多数接近28.0 kg/m²,以28.0 kg/m²作为肥胖切点。结论 本研究在更新开展的大样本调查中进一步验证了中国肥胖问题工作组2002年推荐的超重和肥胖标准,超重和肥胖的BMI切点分别为24.0和28.0 kg/m²;中心性肥胖的腰围适宜切点男性为85 cm,女性为80~85 cm。     

鄂城区居民高血压患病现状及影响因素分析

目的了解鄂州市鄂城区居民高血压患病现状及影响因素,为制定高血压防控策略和措施提供依据。方法采用分层整群抽样方法,随机抽取18岁及以上辖区常住居民进行问卷调查、体格检查和实验室检测。共调查4 440人。结果鄂城区居民高血压患病率为19.46%,男性患病率为21.85%,高于女性的17.19%(P0.05),农村居民患病率为23.20%,高于城区居民的16.31%(P0.05)。多因素Logistic回归分析提示,男性、年龄大(≥35岁)、农村居民、文化程度低、已婚、丧偶或离异、BMI≥24 kg/m2、腰围(男性≥90 cm,女性≥85 cm)和患糖尿病可能是高血压患病的危险因素。结论应加强对高血压危险因素的监测和干预,普及慢病防控知识,降低高血压患病风险。     

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

目的 分析中国成年人高血压的区域聚集性及危险因素,探讨多水平模型在高血压危险因素研究中的应用.方法 采用多阶段随机抽样方法,于2000-2001年从中国10地区共抽得年龄在35～74岁之间的15 540人作为研究对象,采用MLwiN 2.02软件对数据进行二水平logistic回归模型拟合.结果 高血压的患病存在地区聚集现象,方差成分系数为3.1%.在调整了年龄和性别的影响后,全身型肥胖人群(BMI≥28 kg/m2)和超重人群(BMI 24～27.9 kg/m2)分别为BMI正常人群(18.5～23.9 kg/m2)患高血压风险的4.50(95%CI:4.00～5.06)和2.26(95%CI:2.07～2.46)倍;中心型肥胖人群(男性腰围≥85 cm或女性≥80 cm)为正常腰围人群患高血压风险的2.62(95%CI:2.42～2.83)倍;片油三酯、总胆固醇、血糖、低密度脂蛋门胆固醇含量升高或者高密度脂蛋白胆固醇含量降低者患病风险分别为正常者高血压患病风险的2.10(95%CI:1.89～2.33)、2.08(95%CI:1.84～2.35)、1.85(95%CI:1.60～2.14)、1.58(95%CI:1.38～1.81)和1.49(95%CI:1.32～1.69)倍,饮酒人群为不饮酒人群患高血压风险的1.15(95%CI:1.05～1.27)倍.结论 高血压的发生不仪与个体肥胖、血糖升高、血脂异常和饮酒等危险因素有关,还受所居住区域环境因素的影响;在高血压的一级预防中,既要关注高危人群,还要重视以一般人群为基础的群体预防控制工作.     

体质指数、腰围、腰臀比与高血压、高血糖的关系及三者对高血压、高血糖的预测价值

目的探讨体质指数（BMI）、腰围（WC）、腰臀比（WHR）与高血压、高血糖的关系及三者对高血压高血糖的预防价值。方法2006年4-9月整群抽取黑龙江省电力医院健康检查中心体检的1751人,测量身高、体重、腰围、臀围、血压和空腹血糖。结果①BMI、WC与血压的相关性比WHR好;WHR、WC与血糖的相关性比BMI好;②logistic回归分析表明3个指标中BMI是高血压重要的预测因子,而WC是高血糖及二者聚集重要的预测因子;③BMI、WC与WHR三者之间两两指标同时存在时对高血糖、高血压及二者聚集都存在交互作用;④当BMI≥25kg/m2时,其OR值在3.02-4.01之间,ARP在58.13%-69.21%之间,PARP在43.79%-55.77%之间;当WC≥85cm（男性）、WC≥80cm（女性）时,其OR值在4.04-6.70之间,PARP在56.47%-75.52%之间;敏感度和特异度均较好,正确指数高,具有较高的公共卫生价值。结论BMI、WC分别是高血压、高血糖重要的预测因子,以BMI≥25kg/m2或WC≥85cm（男性）、WC≥80cm（女性）为超重肥胖切点时,诊断价值最高,建议以此为诊断界值。     

不同体重指数和腰围水平与其他心血管病危险因素聚集的关系

目的探讨不同体重指数(BMI)和腰围水平对人群中其他心血管病危险因素聚集的影响.方法将1992～1994年和1998年在我国不同地区中年人群中进行的2次心血管病危险因素调查资料合并共30 561人,比较不同BMI和腰围分组的研究对象其他心血管病危险因素聚集率和聚集的相对危险,其中危险因素聚集定义为同一研究对象具有高血压、高血清总胆固醇、低高密度脂蛋白胆固醇或空腹血糖异常之中的任意2项或2项以上者.结果随着BMI和(或)腰围的增加,人群其他心血管病危险因素的聚集率呈明显上升趋势, 按BMI分层各组中,男女两性腰围与其他心血管病危险因素的聚集率均呈明显的线性上升趋势,同样在不同的腰围分组中,BMI均与其他心血管病危险因素的聚集率呈明显的线性趋势.男性和女性年龄调整心血管病危险因素聚集率在BMI<24 kg/m2、腰围(男/女)<85/80 cm组分别为11.1%和10.4%,BMI<24 kg/m2、腰围(男/女)85～95.9/80～89.9 cm组分别为24.2%和16.9%, BMI 24.0～27.9 kg/m2、腰围(男/女)<85/80 cm组分别为24.0%和17.0%,BMI 24～27.9 kg/m2、腰围(男/女)85～95.9 /80～89.9 cm组分别为34.3%和24.0%. BMI 24.0～27.9 kg/m2、腰围(男/女)≥95/90 cm组分别为40.8%和29.6%,BMI≥28 kg/m2、腰围(男/女)85～95.9/80～89.9 cm组分别为44.2%和29.9%,BMI≥28 kg/m2、腰围(男/女)≥95/90 cm组分别为54.7%和35.4%.结论 BMI和腰围水平均与其他心血管病危险因素的聚集有独立的正相关性.保持BMI和腰围均在正常范围对心血管健康是很重要的.     

中国成人腰围、体质指数与高血压关系

目的 采用腰围(WC)、体质指数(BMI)综合评价中国18～69岁成年人中心性肥胖者高血压患病风险.方法 利用2004年中国慢性病及其危险因素监测样本人数,采用多级抽样方法抽取18～69岁成年人30 686人,采用问卷调查和人体测量方法收集数据,比较各BMI组别中心性肥胖者高血压患病的OR值.结果 体质指数正常、超重和肥胖组中,男性中心性肥胖者高血压患病率分别为26.1%,32.0%和49.2%;女性中心性肥胖者高血压患病率分别为22.5%,28.2%和41.5%;除男性肥胖组外,中心性肥胖者高血压患病率均明显高于同组内的正常腰围人数(P<0.01);调整混杂因素(年龄、吸烟状况、饮酒状况和锻炼等)后,与正常腰围人群比较,各BMI组别中男性中心性肥胖者患高血压患病的OR值分别为1.9(95%CI=1.6～2.3),1.6(95%CI=1.3～1.9),1.6(95%CI=0.7～3.7);女性患高血压患病OR值分别为1.5(95%CI=1.3～1.8),1.4(95%CI=0.2～1.6),2.5(95%CI=1.2～5.2).结论 中心性肥胖者与正常腰围者比较具有更高的高血压患病风险.     

Waist circumference, body mass index and health risk factors among middle aged Thais

Body mass index (BMI) and waist circumference (WC) are important contributors to major causes of health risk factors such as high blood cholesterol, high fasting blood sugar and high blood pressure. This analysis was designed to assess the associations between WC, BMI and each health risk factor in suitable cut-off points for WC and BMI among middle aged men and women of Thai population. Cross sectional data from the Second National Health Survey in Thailand was analysed. This set of data collected by the Ministry of Public Health from 1996 to 1997 was obtained from a total of 998 subjects (comprising 396 men and 602 women) aged 45-50. Results from the Receiver Operating Characteristic curve (ROC curve) identified those with health risk factors demonstrating cut-off points for WC between 81.5-84 centimeters for men and 76-80.5 centimeters for women and BMI between 23.3-23.9 kg/m2 for both genders, respectively. Results from the Multiple logistic regression analysis demonstrated lower risks of having high blood cholesterol, high fasting blood sugar and high blood pressure with cutoff points 84 cm for men, 80 cm for women and BMI 23 kg/m2 for both genders compared to cut-off points 102 cm for men, 88 cm for women and BMI 25 kg/m2 for both genders as specified for the population in Western countries. This study has proposed a waist circumference of 84 cm (33.6 inches) for middle aged Thai men and 80 cm (32 inches) for middle aged Thai women and BMI of 23 kg/m2 for both genders. Monitoring changes in the waist circumference over time along with BMI may be convenient and useful for middle aged Thais to prevent health risk conditions, even in the absence of a change in BMI.     

Relative importance of body mass index and waist circumference for hypertension in adults

OBJECTIVE: To assess the relative importance of Body Mass Index (BMI) and waist circumference for the determination of hypertension in adults. METHODS: Cross sectional analysis of a sample of employees (N=1,584), aged 18 to 64 years, from a private general hospital in the city of S?o Paulo, Brazil. Data collection included the application of a structured questionnaire and blood pressure, weight, high, and waist circumference measurements. Hypertension was defined as blood pressure levels >or= 140/90 mmHg or reported use of anti-hypertensive medication. The relative importance of BMI and waist circumference was evaluated by calculating the attributable fraction of hypertension corresponding to each anthropometric indicator, employing both the usual cut-off points as well as cut-off points based on the observed distribution of the indicator in the population. In addition, an indicator combining simultaneously BMI and abdominal circumference values was also developed. RESULTS: Prevalence of hypertension was 18.9% (26.9% in men and 12.5% in women). In men, the fraction of hypertension attributable to BMI exceeded the fraction attributable to waist circumference based on the usual cut-off points for the indicators (56% vs. 48%, respectively) and also considering the quartiles of the observed distribution for these indicators (73% vs. 69%, respectively). In women, the fraction of hypertension attributable to waist circumference was slightly higher than the fraction attributable to BMI based on the usual cut off points for both indicators (44% vs. 41%), but the reverse was true when quartiles of the observed distribution were used (41% vs. 57%, respectively). In women only, the fraction of hypertension attributable to the indicator combining BMI and waist circumference (64%) was higher that observed using each indicator alone. CONCLUSIONS: Both BMI and abdominal circumference were positively and independently associated with the occurrence of arterial hypertension, the influence of BMI being higher among men.     

Varying sensitivity of waist action levels to identify subjects with overweight or obesity in 19 populations of the WHO MONICA Project

It has been suggested in the literature that cut-off points based on waist circumference (waist action levels) should replace cut-off points based on body mass index (BMI) and waist-to-hip ratio in identifying subjects with overweight or obesity. In this article, we examine the sensitivity and specificity of the cut-off points when applied to 19 populations with widely different prevalences of overweight. Our design was a cross-sectional study based on random population samples. A total of 32,978 subjects aged 25–64 years from 19 male and 18 female populations participating in the second MONICA survey from 1987 to 1992 were included in this study. We found that at waist action level 1 (waist circumference ≥94 cm in men and ≥80 cm in women), sensitivity varied between 40% and 80% in men and between 51% and 86% in women between populations when compared with the cut-off points based on BMI (≥25 kg/m²) and waist-to-hip ratio (≥0.95 for men, ≥0.80 for women). Specificity was high (≥90%) in all populations. At waist action level 2 (waist circumference ≥102 cm and ≥88 cm in men and women, respectively, BMI ≥30 kg/m²), sensitivity varied from 22% to 64% in men and from 26% to 67% in women, whereas specificity was >95% in all populations. Sensitivity was in general lowest in populations in which overweight was relatively uncommon, whereas it was highest in populations with relatively high prevalence of overweight. We propose that cut-off points based on waist circumference as a replacement for cut-off points based on BMI and waist-to-hip ratio should be viewed with caution. Based on the proposed waist action levels, very few people would unnecessarily be advised to have weight management, but a varying proportion of those who would need it might be missed. The optimal screening cut-off points for waist circumference may be population specific.     

Predicting incident diabetes in Jamaica: the role of anthropometry

OBJECTIVE: To evaluate the performance of the body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) in predicting incident diabetes in Jamaica. RESEARCH METHODS AND PROCEDURES: A cohort of 728 nondiabetic adults (290 men and 438 women), ages 25 to 74 years and residents of Spanish Town, Jamaica, were followed for a mean of 4 years. Participants had fasting and 2-hour postchallenge glucose concentrations measured at baseline and follow-up. RESULTS: There were 51 cases of incident diabetes (17 men and 34 women). All indices were independent predictors of diabetes, and none was clearly superior. The area under the receiver operating characteristics curves (95% confidence interval) for BMI was 0.74 (0.59 to 0.88) for men and 0.62 (0.51 to 0.72) for women. For waist circumference, these values were 0.78 (0.65 to 0.91) in men and 0.61 (0.50 to 0.71) in women. Similar results were obtained for WHR and WHTR. "Optimal" cut-off points for BMI were 24.8 kg/m(2) (men) and 29.3 kg/m(2) (women). For waist circumference, these were 88 cm and 84.5 cm for men and women, respectively. Corresponding values for WHR were 0.87 and 0.80 and for WHTR were 0.51 and 0.54, respectively. DISCUSSION: Cut-off points for waist circumference and WHR were similar to those proposed in developed countries for women but lower in men. Waist circumference could be useful in health promotion as an alternative to BMI.     

不同体重指数和腰围人群的血压均值及高血压患病率调查

目的：探讨体重指数(BMI和腰围(WC)对人群血压水平和高血压患病率的影响。方法：对1992—1994年和1998年在中国不同地区男女性中年人群中进行的两次心血管病危险因素调查资科合并共35 003人，比较不同BMI和WC分组的平均血压水平及其高血压患病率。结果：随着BMI和／或WC的增加，人群血压水平、高血压患病率呈明显的上升趋势，在多数BMI组中，男女性WC与血压均值和高血压患病车间存在明显的线性相关关系(线性趋势检验P＜0．05)，同样在不同的WC组中，BMI均与血压均值和高血压患病车间存在明显的线性相关关系。男女性按不同BMI及WC标准分组的年龄调整高血压患病率分别为16．5％、14．1％(BMI＜24kg／m^2，男／女：WC＜85／80cm)，29．8％、20．6％(BMI＜24kg／m^2，男／女：WC≥85／80cm)，29．6％、24．7％(BMI：24．0—27．9kg／m^2，男／女：WC＜85／80cm)，39．2％、30．3％(BMI：24．0—27．9kg／m^2，男／女：WC≥85／80cm)，57．5％、43．3％(BMI≥28kg／m^2，男／女：WC≥85／80cm)。结论：BMI和WC均与人群血压有相互独立的关联，保持BMI和WC均在正常范围是预防高血压的有效措施。     

Clothing size as an indicator of adiposity, ischaemic heart disease and cardiovascular risks

OBJECTIVE: To relate subjects' clothing sizes to waist circumference, body mass index (BMI) and to the risks of ischaemic heart disease, hypertension and diabetes mellitus, and to derive cut-off levels of clothing size that correspond to increased health risks. DESIGN: Cross-sectional study. Setting Glasgow Royal Infirmary. PARTICIPANTS: A stratified subsample of 201 men and 161 women aged 27-67 years from the Glasgow monitoring coronary (MONICA) risk factor survey. MAIN OUTCOME MEASURES: Measured waist, weight and height, blood pressure and history of ischaemic heart disease (angina, myocardial infarction or angioplasty), hypertension and diabetes mellitus, and medications. RESULTS: There were 15.5% of men and 11.2% of women with ischaemic heart disease, 14.9% of men and 12.4% of women with hypertension, and 4.5% of men and 3.1% of women with diabetes mellitus. Age and smoking adjusted prevalences of these cardiovascular risks, as well as increased adiposity (waist circumference > or =102 cm in men, > or =88 cm in women or BMI > or = 30 kg m(-2)) rose with increasing clothing size. Clothing size correlated (P < 0.001) linearly with indices of adiposity. Clothing sizes which correspond to waist circumference action level 1 (94 cm in men, 80 cm in women) and action level 2 (102 cm in men, 88 cm in women) or to standardized BMI cut-offs (25 and 30 kg m(-2)) were estimated. Height has minimal influences on clothing size. Compared with men with trouser waist below 36 inches or women with UK dress size below 16, the age and smoking adjusted odds ratios for the risk of having at least one of the major health problems (ischaemic heart disease, hypertension or diabetes mellitus) were 3.9 (95% CI: 1.8-8.3) in men and 7.0 (95% CI: 2.5-19.4) in women who had trouser size > or =38 inches or UK dress size > or =18, respectively. CONCLUSIONS: The present study showed that men and women with large clothing size are at increased risk of ischaemic heart disease, hypertension and diabetes mellitus. Men's trouser size equal or larger than 38 in the UK and USA or 97 in Europe and women's dress size equal or larger than 18 in the UK or 16 in the USA or 48 in Europe could be used to promote self-awareness of increased health risks by the general public.     

Optimal Cut-Off Values of Anthropometric Markers to Predict Hypertension in North Indian Population

The aim of the study was to determine the cut-offs of anthropometric markers for detecting hypertension in an endogamous North Indian population. A cross-sectional study was carried out to collect data from 578 adult Aggarwal Baniya subjects (271 men and 307 women, mean age: 43.4 ± 5.3 and 38.7 ± 4.9 respectively) using multistage, stratified sampling method. Individual body weight, height, waist circumference (WC), hip circumference, blood pressure were assessed. Receiver operating characteristic (ROC) analysis was used to find out the optimal cut-off values of various anthropometric markers to predict hypertension. The likelihood ratios for having hypertension in subjects with various cut-off values were calculated. Logistic regression analysis was used to examine the independent relationship between the anthropometric markers and odds of having hypertension. The BMI cut-off to predict hypertension was 22.8 kg/m² in men and 28.8 kg/m² in women. The optimal WC cut-offs varied from 91–92 cm in both men and women. The WHR cut-off was about 0.90 in men and 0.78 in women respectively, and the optimal WHtR cut-off was 0.56 in men and 0.43 in women. The cut-off levels for BMI, WC and WHtR corresponded to the inflexion points in the likelihood ratio graphs. The area under curve (AUC) and odds ratios showed that the risk of having hypertension was highest with respect to increased BMI and that BMI is the best predictor of having hypertension. The cut-off points for detecting cardiovascular risk factors among our population are lower than the criteria by the World Health Organization. Although these results may not be readily applied to the rest of the Indian populations due to the multiethnic composition, they point to the necessity of similar studies with large randomized samples to find the cut-off levels for chronic conditions in different populations.     

Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea

The aim of this study was first, to investigate the prevalence of obesity, abdominal obesity, and clustering of cardiovascular (CVD) risk factors, and secondly, to identify the BMI or waist circumference (WC) level at which clustering increases in South Koreans. A population-based, cross-sectional National Health Examination Survey was carried out in 1998. A total of 8,816 subjects (4,029 men and 4,787 women) aged 15-79 y were selected by stratified multistage probability sampling design. The measurements taken of the subjects included: height, weight, waist and hip circumference, blood pressure, fasting glucose, and lipids. The prevalence of BMI > or = 25 kg/m2 was 25.3% for men and 28.3% for women. The prevalence of WC >90 cm in men, and >80 cm in women was 18.5%, and 38.5%, respectively. Clustering of 3 or more CVD risk factors was 22.7% in men ad 21.7% in women. Using <21 kg/m2; as a referent, subjects with BMI of 23 kg/m2; and 27 kg/m2; had an odds ratio of 3.5 and 10.2 in men, and 3.1 and 6.7 in women, respectively for clustering of CVD risk factors. Using <65 cm as a referent, subjects with a WC of > or = 90 cm in men and > or = 85 cm in women had an odds ratio of 13.4, and 13.6, respectively for clustering of CVD risk factors. Considering the significant associations between clustering of CVD risk factors and BMI or WC, the present study suggests that high prevalence of overweight may have important implications for the health care system, even at a lower level of BMI or WC.