BMI is Strongly Associated With Hypertension, and Waist Circumference is Strongly Associated With Type 2 Diabetes and Dyslipidemia, in Northern Chinese Adults

Background Obesity is closely associated with chronic diseases such as hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. We analyzed the optimal obesity index cut-off values for metabolic syndrome (MetS), and identified the obesity index that is more closely associated with these chronic diseases, in a population of northern Chinese. Methods We surveyed 8940 adults (age, 20–74 years) living in northern China for chronic diseases. Receiver operating characteristics (ROC) analysis, relative risk, and multivariate regression were used to develop an appropriate index and optimal cut-off values for MetS and obesity-related chronic diseases. Results Waist circumference (WC) and body mass index (BMI) were good markers for MetS, WC was a good marker for T2DM and dyslipidemia, and BMI was a good marker for hypertension. The optimal BMI cut-off value of MetS was 24 kg/m2, and the optimal WC cut-offs were 86 cm and 78 cm in men and women, respectively. Relative risk regression models showed that BMI was associated with hypertension, T2DM, and hypertriglyceridemia and a higher prevalence ratio (PR) for hypertension: 2.35 (95% CI, 2.18–2.50). WC was associated with T2DM, hypertension, and hypertriglyceridemia, with PRs of 2.05 (1.63–2.55) for T2DM and 2.47 (2.04–2.85) for hypertriglyceridemia. In multivariate regression models, the standardized regression coefficients (SRCs) of BMI were greater for SBP and DBP, and the SRC of WC was greater for fasting blood glucose, 2-hour postload blood glucose, triglyceride, and total cholesterol. Conclusions Our analysis of a population of northern Chinese indicates that the optimal cut-off values for MetS are WCs of 86 cm in men and 78 cm in women and a BMI of 24 kg/m2 in both sexes. BMI was strongly associated with hypertension, while WC was strongly associated with T2DM and dyslipidemia.

[1]  S. Haffner,et al.  The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. , 2003, Diabetes care.

[2]  A. Akabayashi,et al.  Effective cut-off values of waist circumference to detect the clustering of cardiovascular risk factors of metabolic syndrome in Japanese men and women , 2007, Diabetes & vascular disease research.

[3]  Donna Spiegelman,et al.  Easy SAS calculations for risk or prevalence ratios and differences. , 2005, American journal of epidemiology.

[4]  S. Y. Lee,et al.  Appropriate waist circumference cutoff points for central obesity in Korean adults. , 2007, Diabetes research and clinical practice.

[5]  Bei-fan Zhou.  Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. , 2002, Biomedical and environmental sciences : BES.

[6]  E. Rimm,et al.  Adiposity and mortality in men. , 2000, American journal of epidemiology.

[7]  B. Popkin,et al.  Prediction of hypertension by different anthropometric indices in adults: the change in estimate approach , 2009, Public Health Nutrition.

[8]  Ho-Young Son,et al.  Epidemic obesity and type 2 diabetes in Asia , 2006, The Lancet.

[9]  R. Stein,et al.  Evolving Cardiovascular Disease Prevalence, Mortality, Risk Factors, and the Metabolic Syndrome in China , 2009, Clinical cardiology.

[10]  Takeo Kato,et al.  A proposal for the cutoff point of waist circumference for the diagnosis of metabolic syndrome in the Japanese population. , 2006, Circulation journal : official journal of the Japanese Circulation Society.

[11]  N. Tajima,et al.  Prevalence of metabolic syndrome and optimal waist circumference cut-off values in Japan. , 2007, Diabetes research and clinical practice.

[12]  S. Grundy,et al.  Ten-year cardiovascular disease risk of metabolic syndrome without central obesity in middle-aged chinese. , 2007, The American journal of cardiology.

[13]  Vishal Sharma,et al.  Diabetes in Asia , 2010, The Lancet.

[14]  B. Howard,et al.  Obesity and dyslipidemia. , 2003, Endocrinology and metabolism clinics of North America.

[15]  J. Manson,et al.  Body mass index and mortality among US male physicians. , 2004, Annals of epidemiology.

[16]  R. Nyamdorj.  BMI Compared With Central Obesity Indicators in Relation to Diabetes and Hypertension in Asians , 2008, Obesity.

[17]  G. Ko,et al.  Waist Circumference and BMI Cut‐off Based on 10‐year Cardiovascular Risk: Evidence for “Central Pre‐Obesity” , 2007, Obesity.

[18]  A. Iwabu,et al.  Inverse Correlation Between Seasonal Changes in Home Blood Pressure and Atmospheric Temperature in Treated-Hypertensive Patients , 2010, Clinical and experimental hypertension.

[19]  Ken Williams,et al.  Which Obesity Index Best Explains Prevalence Differences in Type 2 Diabetes Mellitus? , 2007, Obesity.

[20]  Jing Chen,et al.  Prevalence of the metabolic syndrome and overweight among adults in China , 2005, The Lancet.

[21]  S. Yusuf,et al.  Anthropometric measures and glucose levels in a large multi-ethnic cohort of individuals at risk of developing type 2 diabetes , 2010, Diabetologia.

[22]  K. Reynolds,et al.  Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) , 2003, Diabetologia.

[23]  Xi-gui Wu,et al.  A north‐south comparison of blood pressure and factors related to blood pressure in the People's Republic of China: a report from the PRC‐USA Collaborative Study of Cardiovascular Epidemiology , 1994, Journal of hypertension.

[24]  E. Oda,et al.  Body mass index is more strongly associated with hypertension than waist circumference in apparently healthy Japanese men and women , 2010, Acta Diabetologica.

[25]  Y. Li,et al.  Effects of multivitamin and mineral supplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women , 2010, International Journal of Obesity.

[26]  Wyndham Ch,et al.  Climate and disease. , 1978, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[27]  A. C. Neiswander.  Climate and disease. , 1963, Journal of the American Institute of Homeopathy.

[28]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[29]  J. Buring,et al.  Abdominal and total adiposity and risk of coronary heart disease in men , 2001, International Journal of Obesity.

[30]  K. Xiang,et al.  Optimal waist circumference cutoffs for abdominal obesity in Chinese. , 2008, Atherosclerosis.

[31]  B. Howard,et al.  Risk Factors for Arterial Hypertension in Adults With Initial Optimal Blood Pressure: The Strong Heart Study , 2006, Hypertension.

[32]  S. Kaneko,et al.  BMI May Be Better Than Waist Circumference for Defining Metabolic Syndrome in Japanese Women Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc07-0309. , 2008, Diabetes Care.

[33]  J. Shaw,et al.  Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes Federation , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[34]  R. Feng,et al.  Dietary Calcium but Not Elemental Calcium from Supplements Is Associated with Body Composition and Obesity in Chinese Women , 2011, PloS one.

[35]  Jing Chen,et al.  Geographic variations in the prevalence, awareness, treatment and control of hypertension in China , 2003, Journal of hypertension.