Correlation and prediction of trunk fat mass with four anthropometric indices in Chinese males

To increase our understanding of the relationships of trunk fat mass (FMtrunk) and four anthropometric indices in Chinese males, 1090 males aged 20-40 years were randomly recruited from the city of Changsha, China. Waist circumference (WC) and hip circumference (HC) were measured using standardized equipment, and three other anthropometric indices of BMI, waist:hip ratio (WHR) and conicity index (CoI) were calculated using weight, height, HC and WC. FMtrunk (in kg) was measured using a Hologic QDR 4500 W dual-energy X-ray absorptiometry scanner. There was an increasing trend of FMtrunk, %FMtrunk (percentage of FMtrunk) and BMI, WC, WHR, CoI in successively older age groups (e.g. the mean FMtrunk values were 4.63 (SD 2.58), 5.39 (SD 2.74), 5.93 (SD 2.82), 6.57 (SD 2.94) in four 5-year age groups, respectively). FMtrunk and %FMtrunk were significantly correlated with four anthropometric indices with the Pearson's correlation coefficients ranging from 0.25 to 0.86. Principal component analysis was performed to form three principal components that interpreted over 99.5% of the total variation of four related anthropometric indices in all age groups, with over 65% of the total variation accounted by principal component 1. Multiple regression analyses showed that three principal components explained a greater variance (R(2) 70.0-80.1%) in FMtrunk than did BMI or WC alone (R(2) 57.8-74.1%). The present results suggest that there is an increasing trend of FMtrunk and four anthropometric indices in successively older age groups; that age has important effects on the relationships of FMtrunk and studied anthropometric indices; and that the accuracy of predicting FMtrunk using four anthropometric indices is higher than using BMI or WC alone.     

Waist-hip ratio and waist circumference associated with body mass index in a study with schoolchildren

The objectives of this study were to determine the percentile levels of the anthropometric indices body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) and to verify possible correlations among theses indices in schoolchildren registered at the State Institute of Education, Florianópolis, Santa Catarina State, Brazil. A total of 419 children ages 7 to 9 years were investigated: 215 (51.3%) boys and 204 (48.7%) girls. BMI, WHR, and WC were higher for boys than for girls. However, the differences were only statistically significant for WHR and WC. Prevalence rates were 17.9% for overweight and 6.7% for obesity. The anthropometric indices with the highest correlation were BMI and WC (r = 0.87 and p < 0.01). For overweight, BMI and WC also presented the strongest correlation (r = 0.74). For obesity, WHR and WC showed the best correlation (r = 0.54).     

苏州市成年人身体测量指标与糖尿病患病关系的研究

目的 探讨成年人身体测量指标与糖尿病患病的关系.方法 利用“中国慢性病前瞻性研究”(CKB)苏州市项目点53 260名30～79岁常住居民有效基线调查数据,通过logistic多元回归分析研究身体测量指标与糖尿病患病的关系.结果 调查人群糖尿病患病率为5.3%,其中半数为新检测发现患者.糖尿病患病率随年龄增加而升高,年龄每增加10岁,患病风险增加61%(OR=1.61,95%CI:1.54～1.67).无论男女性别,BMI、体脂比、腰围、臀围、腰臀比和腰身比均与糖尿病患病呈显著正相关.中心性肥胖指标与糖尿病患病风险的关系强于全身性肥胖指标,其中腰臀比与糖尿病患病风险的关系最强.腰臀比每增加1个标准差(s),男性(s=0.06)的糖尿病患病风险增加72%(61%～83%),女性(s=0.07)增加93%(83%～102%).在同一分析模型中“腰围”和“臀围”相互调整后,腰围值每增加5 cm,男女性糖尿病患病风险性分别增加65%和57%;但臀围值每增加5 cm,男女性糖尿病患病风险性分别减少38%和34%.结论 BMI、体脂比、腰围、腰臀比和腰身比等肥胖测量指标均与糖尿病患病呈显著正相关;中心性肥胖指标,尤其是“腰臀比”,与糖尿病患病风险的关系强于全身性肥胖指标.控制“腰围”后,“臀围”与糖尿病患病呈显著负相关.     

Receiver-operating characteristic analyses of body mass index, waist circumference and waist-to-hip ratio for obesity: Screening in young adults in central south of China

BACKGROUND & AIMS: Recent data suggest that current obesity diagnostic criterion based on body mass index (BMI) above 30 in Caucasians may not be appropriate for Asian populations. Our aim was to identify the usefulness of BMI, waist circumference (WC) and waist-to-hip ratio (WHR) in screening for obesity in an Asian population. METHODS: A cross-sectional sample of 1109 males and 879 females aged 20-45-yr were recruited. Height, weight, WC, hip circumference and percentage body fat (PBF) were measured in all subjects. Then receiver-operating characteristic analyses were used to evaluate the performances of the three anthropometric indices. RESULTS: BMI, WC and WHR showed strong positive correlation with PBF (r=0.47-0.75) in both males and females within both age groups. True-positive rates ranged from 82.4% to 94.1% and 68.8% to 86.3% in males and females, respectively. True-negative rates ranged from 64.1% to 84.7% and from 56.9% to 79.0%, respectively. The areas under the curves (AUCs) for WC and BMI were high (0.76-0.92) in both sexes and divided age groups (20-30-yr and 31-45-yr), and those for WHR were a little lower (0.74-0.88). CONCLUSIONS: BMI and WC are two important predictors for obesity in Chinese, and WHR is an alternative.     

Indirect Predictors of Visceral Adipose Tissue in Women with Polycystic Ovary Syndrome: A Comparison of Methods

Visceral adipose tissue (VAT) accumulation, is a part of a polycystic ovary syndrome (PCOS) phenotype. Dual-energy x-ray absorptiometry (DXA) provides a gold standard measurement of VAT. This study aimed to compare ten different indirect methods of VAT estimation in PCOS women. The study included 154 PCOS and 68 age- and BMI-matched control women. Subjects were divided into age groups: 18–30 y.o. and 30–40 y.o. Analysis included: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist/height 0.5 (WHT.5R), visceral adipose index (VAI), lipid accumulation product (LAP), and fat mass index (FMI). VAT accumulation, android-to-gynoid ratio (A/G), and total body fat (TBF) was measured by DXA. ROC analysis revealed that WHtR, WHT.5R, WC, BMI, and LAP demonstrated the highest predictive value in identifying VAT in the PCOS group. Lower cut-off values of BMI (23.43 kg/m²) and WHtR (0.45) were determined in the younger PCOS group and higher thresholds of WHtR (0.52) in the older PCOS group than commonly used. Measuring either: WHtR, WHT.5R, WC, BMI, or LAP, could help identify a subgroup of PCOS patients at high cardiometabolic risk. The current observations reinforce the importance of using special cut-offs to identify VAT, dependent on age and PCOS presence.     

Smoking status and body fatness indicators: a cross-sectional survey among 1948 Chinese male adults

Aim

The relationship between cigarette smoking and obesity has been extensively studied, but the existing evidence is inconclusive. Moreover, few previous studies had examined the relationships of cigarette smoking with body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) simultaneously, which could not fully assess the effects of smoking on fat distribution. This study aimed to investigate the associations of cigarette smoking with BMI, WC, HC and WHR in Chinese male adults.

Subjects and methods

A total of 1,948 Chinese male adults (including 982 non-smokers, 846 current smokers and 210 former smokers) were selected from a community-based chronic disease screening project in Guangzhou and Zhuhai, China. The selected subjects were surveyed about their smoking status and history, and their body fatness indicators (BMI, WC, HC and WHR) were measured. A series of analyses of covariance (ANCOVA) were performed to assess associations between smoking behaviors and the body fatness indicators with adjustment for potential confounders.

Results

Current smokers had lower BMI (23.3 vs. 23.5 kg/m²) and HC (93.5 vs. 94.1 cm) but higher WHR (0.867 vs. 0.859) than non-smokers. Within current smokers, heavy smokers (>15 cigarettes/day) had higher BMI (23.4 vs. 23.0 kg/m²) than light smokers (1–15 cigarettes/day) without controlling for WC, but this association was reversed after adjusting for WC (23.1 vs. 23.3 cm). Heavy smokers had higher WC and WHR but lower HC than non-smokers. Former smokers who had quit for shorter than 1 year had larger BMI than non-smokers and former smokers who quitted for 1 year or longer.

Conclusions

Cigarette smoking is associated with both of the reduced total body mass and the increased waist fat deposit, and the weight gain seems to occur and complete itself in a short time after smoking cessation. These findings may improve the understanding on how cigarette smoking is linked to fat distribution and provide scientific evidence regarding intervention in smoking and obesity.     

Assessment of body fatness in young children using the skinfold technique and BMI vs body water dilution

OBJECTIVES: To compare body fatness estimated using a skinfold technique and body mass index (BMI) with body fatness estimated using the body water dilution method in healthy Swedish children 9 or 14 months of age. METHODS: Total body fat (TBF) was calculated from total body water, estimated using the doubly labelled water method, and body weight. When expressed in per cent of body weight, these estimates (%TBF-BWD) represented reference values for body fatness. Body fatness was also calculated from skinfold thickness (%TBF-SFT) and as BMI. The children were ranked and grouped into five groups with an increasing level of body fatness using BMI, %TBF-SFT and %TBF-BWD, respectively. SUBJECTS: A total of 30 infants 9 months of age and 29 children 14 months of age. RESULTS: On average, the children (n=59) had a BMI=17.5+/-1.6 kg/m(2) and contained 27.8+/-3.7 %TBF-SFT and 29.1+/-4.4 %TBF-BWD. %TBF-BWD minus %TBF-SFT was=1.35+/-4.06%. By measuring %TBF-SFT or BMI, about 35% of the children could be classified in the correct group with respect to body fatness. Serious misclassification (ie two or more groups too high or too low) was, however, more common for %TBF-SFT (29%) than for BMI (17%). CONCLUSIONS: The capacity of BMI to place children in the correct body fatness group was poor although not quite as poor as the corresponding capacity of the skinfold technique. The latter method produced inaccurate and imprecise estimates of body fatness.     

简易体脂参数估测腹内型肥胖的可靠性评价

目的：评价体重指数（BMI）、腰围（WC）、腰臀比（WHR）估测腹内型肥胖的最佳临界点及敏感度、特异度。方法：应用核磁共振（MRI）对690名受试者（男305人，女385人）进行腹内脂肪（VA）测量，同时测量BMI、WC、WHR。以受试者工作特性（ROC）曲线评价简易体脂参数对腹内型肥胖的诊断价值。结果：①经MRI诊断，超重／肥胖者中61．7％，正常体重者中14．2％呈腹内型肥胖（VA≥100cm^2）；②BMI、WC、WHR与腹内脂肪面积呈显著正相关，尤以WC的相关性最好;③简易体脂参数估测腹内脂肪积聚的最佳切割点为BMI：26kg/m^2,WC:90cm,WHR:0.93;④BMI≥28kg/m^2、WC≥95cm时，95％的男性及90％左右的女性呈腹内型肥胖。结论：BMI、WC及WHR都可估测腹内型肥胖，但以腰围的准确率稍高。     

Simple anthropometric measures correlate with metabolic risk indicators as strongly as magnetic resonance imaging-measured adipose tissue depots in both HIV-infected and control subjects

BACKGROUND: Studies in persons without HIV infection have compared percentage body fat (%BF) and waist circumference as markers of risk for the complications of excess adiposity, but only limited study has been conducted in HIV-infected subjects. OBJECTIVE: We compared anthropometric and magnetic resonance imaging (MRI)-based adiposity measures as correlates of metabolic complications of adiposity in HIV-infected and control subjects. DESIGN: The study was a cross-sectional analysis of 666 HIV-positive and 242 control subjects in the Fat Redistribution and Metabolic Change in HIV Infection (FRAM) study assessing body mass index (BMI), waist (WC) and hip (HC) circumferences, waist-to-hip ratio (WHR), %BF, and MRI-measured regional adipose tissue. Study outcomes were 3 metabolic risk variables [homeostatic model assessment (HOMA), triglycerides, and HDL cholesterol]. Analyses were stratified by sex and HIV status and adjusted for demographic, lifestyle, and HIV-related factors. RESULTS: In HIV-infected and control subjects, univariate associations with HOMA, triglycerides, and HDL were strongest for WC, MRI-measured visceral adipose tissue, and WHR; in all cases, differences in correlation between the strongest measures for each outcome were small (r 相似文献   

北京市城区9～10岁儿童肥胖相关指标与血脂水平关系的探讨

目的分析北京市城区儿童体重指数（BMI）、体脂百分含量及腰围与血脂谱的关系。方法采用随机整群抽样法抽取852名北京市城区9～10岁学生，血脂使用自动生化分析仪进行测定。Fisher确切概率法，有序资料的趋势性检验及中位数回归等统计学方法，分析了其中847份有效样本。结果随BMI、体脂百分含量和腰围的增加，总三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）有升高的趋势，高密度脂蛋白胆固醇（HDL—C）有降低的趋势，组间差异均有统计学意义（P〈0．01）。TG主要受腰围（t=686）、性别（t=3．96）、体脂百分含量（t=1．85）影响；TC受体脂百分含量（t=5．31）影响；LDL—C受腰围（t=4．65）、身高（t=-2．79）、体脂百分含量（t=2．77）影响；HDL-C主要受腰围（t=-12．24）、性别（t=-5.83）影响。结论随着肥胖程度的增加，儿童血脂水平上升，且腰围对血脂水平的预测能力最强。     

Diagnostic value of anthropometric indices for initial stage of atherosclerosis in adult women

Excess body weight is a cardiovascular risk factor. The relationship between anthropometric indices and cardiovascular health is not completely understood. Carotid Intima-Media Thickness (CIMT) is a subclinical marker of atherosclerosis. This study aimed to investigate the best anthropometric obesity indicator for diagnosis of initial stage of atherosclerosis by CIMT. This cross-sectional study included 100 adult women, aged 18-50 years. Anthropometric indices were measured with standard protocol and CIMT was measured by non-invasive ultrasound. Receiver Operating Characteristics (ROC) curve analysis was carried out to determine the optimal cut-off values of anthropometric indices, and the best indices for atherosclerosis diagnosis. On ROC curve analysis the suggested appropriate cut-offs of waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), body mass index (BMI) and percentage body fat (%BF) were 96 cm, 0.86, 0.64, 31.29 kg/m2 and 30.42%, respectively. The area under the ROC curve of BMI (AUC=0.74, 95%CI=0.62-0.86) and WHtR (AUC=0.74, 95%CI=0.63-0.85) were greater than other anthropometric indices. The AUC for WHR was the lowest among the studied obesity indices AUC=0.68 (95% CI=0.54-0.81). In our study, WHtR and BMI were the best diagnostic parameters of initial stage of atherosclerosis while WHR was the worst based on AUC.     

农村中老年高血压患者血压水平与身体测量指标的相关性研究

目的 探讨农村社区中老年高血压患者血压水平与肥胖相关身体测量指标的关系.方法 采用横断面调查方法,对连云港农村社区9 991名45 ～75岁原发性高血压患者进行流行病学问卷调查,测量血压,并计算身体测量指标,包括体质指数、腰围、腰臀比、腰围身高比、锥削度指数等.结果 除了女性锥削度指数,舒张压在其他各项肥胖指标四分位数组的分布均呈逐渐升高趋势(均有P＜0.001);多元线性回归分析表明,在调整了年龄、血糖、血脂、吸烟、饮酒等混杂因素后,体质指数、腰围身高比、腰臀比与男性高血压患者的收缩压相关,其中体质指数影响最大(β=1.011,R2=0.052,P=0.002);体质指数、腰围身高比、腰围与女性高血压患者的收缩压相关,以体质指数影响最大(β=0.870,R2=0.040,P＜0.001).各肥胖指标对男女性舒张压影响均有统计学意义(均有P＜0.001),以体质指数影响最大(β=2.001,R2=0.147,P＜0.001).结论 各项肥胖指标均能不同程度的反映农村社区中老年高血压人群的血压水平,其中体质指数与其血压水平关联更为密切.     

体脂分布特征与血脂关系及其预测血脂异常的观察

目的 研究体脂分布特征与血脂关系及其预测血脂异常的价值.方法 采用整群抽样方法抽取北京市郊区居民有效样本784名,测量其身高、体重、腰围(WC)、臀围、身体成分与高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG),并计算体重指数(BMI)与腰臀比(WHR).结果 年龄调整偏相关分析显示WC与HDL-C(r=-0.310)、LDL-C(r =0.204),WHR与TC (r=0.151)、TG (r=0.271)的相关性最好.BMI、WC、WHR、躯干脂肪质量(TFM)分组分析显示WC、WHR、TFM能敏感地反应人体血脂水平的变化;BMI、WC、WHR、TFM能敏感地反应低HDL、高TG及血脂异常的风险.ROC曲线分析显示WC、WHR、BMI、TFM预测血脂异常风险的ROC曲线皆在参考线上方,且男女受试者WHR (0.684、0.630)、WC (0.667、0.616)、TFM(0.661、0.604)的ROC曲线下面积有大于BMI (0.629、0.597)的趋势,但差异均无统计学意义(P＞0.05).结论 体脂分布特征指标如WHR、WC、TFM与BMI相比,在预测血脂异常风险中的应用价值更高;以Youden指数最大值为判定依据预测血脂异常风险,男性理想界值点BMI为24 kg/m2,WHR为0.91,WC为85 cm,TFM为7.5 kg;女性BMI为25 kg/m2,WHR为0.91,WC为87 cm,TFM为9.Skg.由于样本量较少,有待进一步扩大范围的研究.     

成人体重指数和总体脂肪与血脂异常的相关性

目的观察成人体重指数(BMI)、总体脂肪率及分布与血脂异常的相关性。方法对2006年1月至2007年4月在北京协和医院接受年度查体的302例健康成人进行横断面调查,采用多频生物电阻抗测定体重(BW)、总体脂肪(TBF)、腹部脂肪(AF)、内脏脂肪(VF)、内脏脂肪面积(VFA)和腰臀围比值(WHR),同时测定血清甘油三酯(TG)、总胆固醇(CHO)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C),分析BMI、TBF及分布与血脂异常的相关性。结果男性BMI肥胖和超重的发生率、WHR异常和血脂异常的发生率均显著高于女性(P<0.05),但女性表现为TBF%显著增高(P<0.05)。超重和肥胖组的TBF、WHR、AF、VF、VFA、CHO、TG和LDL-C均显著高于体重正常组(P<0.05)。血脂正常组,女性BMI和TBF与CHO、TG和LDL-C呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。血脂异常组,男性和女性均表现为BMI和TBF与TG呈正相关(P<0.05),男性BMI和TBF与TG和HDL-C呈负相关(P<0.05)。结论肥胖/超重和体脂总量超标可增加成年男性和女性血脂异常的发生风险。     

Measures of adiposity in the identification of metabolic abnormalities in elderly men

BACKGROUND: Body mass index (BMI; in kg/m(2)) is considered a poor indicator of overall and abdominal obesity in the elderly. OBJECTIVES: Our goal was to determine which simple anthropometric measurements [BMI, waist-to-hip ratio (WHR), waist circumference (WC), percentage body fat (%BF), or fat mass (FM)] are most closely associated with metabolic risk factors and insulin resistance in elderly men. DESIGN: This was a cross-sectional study of 2924 men aged 60-79 y with no history of coronary heart disease, stroke, or diabetes who were drawn from general practices in 24 British towns. RESULTS: BMI and WC were the measures most strongly associated with the metabolic syndrome (>/=3 of the following: hypertension, low HDL cholesterol, high triacylglycerols, or high blood glucose) and insulin resistance. For a 1-SD increase in BMI, WC, WHR, %BF, and FM, the odds ratios (95% CIs) of having the metabolic syndrome after adjustment for age, socioeconomic status, smoking status, and physical activity were as follows: BMI, 1.61 (1.44, 1.79); WC, 1.65 (1.48, 1.81); WHR, 1.49 (1.34, 1.66); %BF, 1.41 (1.25, 1.59); and FM, 1.53 (1.38, 1.70). For insulin resistance, the odds ratios (95% CIs) were as follows: 2.48 (2.22, 2.77), 2.46 (2.19, 2.65), 1.75 (1.59, 1.93), 1.79 (1.60, 2.00), and 2.10 (1.88, 2.34), respectively. In normal-weight (BMI < 25) and overweight (BMI 25-29.9) men, the presence of the metabolic syndrome and insulin resistance increased with increasing WC; this did not occur in obese men. CONCLUSIONS: BMI and WC are the simple measures of adiposity most strongly associated with metabolic abnormalities in elderly men. Our findings suggest that WC can be used as a complementary measurement to identify health risks in normal-weight and overweight elderly persons.     

Use of height3:waist circumference3 as an index for metabolic risk assessment?

Current anthropometric indices for health risk assessment are indirect measures of total or visceral body fat mass that do not consider the inverse relationship of lean body mass to metabolic risk as well as the non-linear relationship between central obesity and insulin resistance. We examined a new anthropometric index that reflects the relationship of waist circumference (WC) as a risk factor to fat-free mass (FFM) as a protective parameter of body composition. In a population of 335 adults (191 females and 144 males; mean age 53 (SD 13.9) years) with a high prevalence of obesity (27%) and metabolic syndrome (30%) we derived FFM:WC(3) from the best fit of the relationship with metabolic risk factors (plasma triacylglycerol levels and insulin resistance by homeostasis model assessment index). Because FFM is known to be proportional to the cube of height, FFM was subsequently replaced by height(3) yielding height(3):WC(3) as an easily applicable anthropometric index. Significant inverse relationships of height(3):WC(3) to metabolic risk factors were observed for both sexes. They slightly exceeded those of conventional anthropometric indices such as BMI, WC or WC:hip ratio in women but not in men. The exponential character of the denominator WC(3) implies that at a given FFM with gradually increasing WC the increase in metabolic risk is lower than proportional. Further studies are needed to evaluate height(3):WC(3) as an anthropometric index for health risk assessment.     

Anthropometry of elderly residents in the city of São Paulo, Brazil

The article presents gender and age-specific selected anthropometric data for a representative sample of elderly Brazilians in the city of S?o Paulo. This was a cross-sectional, population-based household survey. A total of 1,894 older adults (men and women, > 60 years) were examined from January to March 2001. Data were presented as means and percentiles for body mass (BM); height or stature (ST); body mass index (BMI); waist (WC), hip (HC), arm (AC), and calf (CC) circumferences; triceps skinfold thickness (TST); and arm muscle circumference (AMC), and differences were described according to age (all variables) and gender (BMI). Except for HC (men), all anthropometric variables were lower in the oldest than in the youngest individuals (p < 0.01) in both genders. BMI was significantly higher (p < 0.01) in women than men (all age groups). The observations suggest that there is loss of muscle mass and redistribution and reduction of fat mass with age (both genders). The data can be used in clinical practice and epidemiological studies based on interpretation of anthropometric measurements in the elderly in S?o Paulo.     

Comparison of dual-energy x-ray absorptiometric and anthropometric measures of adiposity in relation to adiposity-related biologic factors

Dual-energy x-ray absorptiometry (DXA) can provide accurate measurements of body composition. Few studies have compared the relative validity of DXA measures with anthropometric measures such as body mass index (BMI) and waist circumference (WC). The authors compared correlations of DXA measurements of total fat mass and fat mass percent in the whole body and trunk, BMI, and WC with obesity-related biologic factors, including blood pressure and levels of plasma lipids, C-reactive protein, and fasting insulin and glucose, among 8,773 adults in the National Health and Nutrition Examination Survey (1999-2004). Overall, the magnitudes of correlations of BMI and WC with the obesity-related biologic factors were similar to those of fat mass or fat mass percent in the whole body and trunk, respectively. These observations were largely consistent across different age, gender, and ethnic groups. In addition, in both men and women, BMI and WC demonstrated similar abilities to distinguish between participants with and without the metabolic syndrome in comparison with corresponding DXA measurements. These data indicate that the validity of simple anthropometric measures such as BMI and WC is comparable to that of DXA measurements of fat mass and fat mass percent, as evaluated by their associations with obesity-related biomarkers and prevalence of metabolic syndrome.     

Anthropometric indices as screening tools for cardiovascular risk factors in Singaporean women

Previous studies have suggested the need to revise the World Health Organization (WHO) cut-off values for the various indices of obesity and fat distribution in Singapore. The purpose of this study was to delineate cut-off points of body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), and waist-stature ratio (WSR) as screening tools for cardiovascular risk factors in Singaporean women. Anthropometric indices were measured in a cross sectional survey of 566 subjects (60% Chinese individuals, 28% Malay individuals and 12% Indian individuals). Cardiovascular risk factors were determined by measuring blood pressure, serum lipids, and fasting blood glucose levels. Receiver Operating Characteristic (ROC) curves were constructed to determine cut-off points. Forward logistic regression and area under curves (AUC) were used to determine the best anthropometric index. For at least one cardiovascular risk factor (hypertension, dyslipidaemia and diabetes mellitus), the cut-off points for BMI, WHR, WC and WSR were around 23.6 kg/m(2), 0.80, 77.8 cm and 0.48 for Singaporean females. The AUC of WSR was the highest for all three risk factors in females (0.79 for hypertension, 0.70 for dyslipidaemia, 0.88 for diabetes mellitus). Regression analyses revealed that WSR was independently associated with all risk factors. For Singaporean female adults, the cut-off points were lower than the criteria suggested by the WHO, but were in agreement with those reported for Asians. BMI, WHR, WC and WSR may be used as screening tools for cardiovascular risk factors, of which WSR may be the best anthropometric index.