Anthropometric Measurements for Prediction of Metabolic Risk among Chinese Adults in Pudong New Area of Shanghai

Anthropometric Cut-Off Values for Detecting the Presence of Metabolic Syndrome and Its Multiple Components among Adults in Vietnam: The Role of Novel Indices

Recent studies have shown that using international guidelines to diagnose metabolic syndrome (MetS) may underestimate its prevalence in different Asian populations. This study aims to determine the validity of anthropometric indicators and appropriate cut-off values to predict MetS for Vietnamese adults. We analyzed data on 4701 adults across four regions of Vietnam. Four conventional and five novel anthropometric indexes were calculated. The area under a receiver operating characteristic (ROC) curve (AUC) and Youden’s J statistic were applied to evaluate the diagnostic ability and optimal cut-off values. Regardless of diagnostic criteria and gender, Abdominal volume index (AVI), Body roundness index (BRI), and Waist-height ratio (WHtR) had the highest AUC values, followed by Body mass index (BMI) and Waist-hip ratio (WHR). However, it was seen that differences among the AUC values of most indices were minor. In men, using International Diabetes Federation (IDF) criteria, the threshold of indices was 3.86 for BRI, 16.20 for AVI, 0.53 for WHtR, 22.40 for BMI, and 0.90 for WHR. In women, the threshold for these figures were 3.60, 12.80, 0.51, 23.58, and 0.85, respectively. It is recommended that health personnel in Vietnam should apply appropriate thresholds of anthropometry, which are lower than current international guidelines, for MetS screening to avoid under-diagnosis.

Predictive Capacity and Cutoff Value of Waist-to-Height Ratio in the Incidence of Metabolic Syndrome

The purpose of this study was to compare the predictive ability of waist-to-height ratio (WHtR) compared with other anthropometric indicators in the incidence of metabolic syndrome (MetS) and to propose cutoff values for its early detection in nursing practice. A longitudinal cohort study was conducted on a sample of 630 workers (137 exposed and 493 nonexposed), free of MetS at baseline. WHtR was compared with body mass index (BMI), waist circumference (WC), and the percentage of body fat (BF%). In the Cox regression, the adjusted values of hazard ratio (HR) were 5.4 (confidence interval [CI] = [3.1, 9.5]) for WHtR and 7.4 (CI = [3.7, 14.9]) for components of MetS. WHtR obtained the largest area under the curve 0.82 (CI = [0.76, 0.88]), and with a cutoff value of 0.54, values were obtained for sensitivity (70%) and specificity (77%). WHtR was the best predictor of incidence of MetS, with a cutoff value of 0.54. Nursing can improve the early detection of MetS by measuring WHtR.

Neck circumference and prehypertension: the cardiometabolic risk in Chinese study

BACKGROUND

We have previously found that neck circumference was related to insulin resistance, a risk factor for hypertension in Chinese. Little is known about whether high neck circumference is associated with elevated blood pressure.

METHOD

The study samples were from a community-based health examination survey in central China. In total, 1709 men and women with neck circumference measurement were included. We analysed the associations between neck circumference and the risk of prehypertension.

RESULTS

Although neck circumference was strongly associated with SBP/DBP in a univariate analysis, it was no longer associated with SBP and the association was much weaker with DBP when the association was adjusted for BMI or waist circumference. Similarly, high neck circumference was significantly related to an increased risk of prehypertension [odds ratio 1.254; 95% confidence interval (95% CI) 1.171-1.343] in a univariate analysis, and the association became marginal in models further adjusting for BMI or waist.

CONCLUSION

Our data suggest that neck circumference as predictor for prehypertension is not obvious given the moderate improvement of disease prediction.

Utility of anthropometric measures in a multiethnic population: their association with prevalent diabetes, hypertension and other chronic disease comorbidities

Body mass index (BMI) and waist circumference (WC) are two common anthropometric measures of obesity in clinical and public health practice. Consensus, however, remains elusive regarding their utility for predicting cardiovascular disease risk in multiethnic populations. We address this gap in the literature by analyzing cross-sectional data from the first round of the Los Angeles County Health and Nutrition Examination Survey, 2011. We characterized the relationships between BMI, WC, waist-to-hip ratios, waist-to-height ratios, and chronic disease extent, as confirmed by the presence of hypertension, diabetes, and/or two or more other chronic conditions as defined by a composite indicator 'comorbidity'. To account for race/ethnicity, age, gender, and cigarette smoking frequency, adjusted odds ratios (aOR) were generated and reported for each of the regression analyses. Whereas being overweight was associated with hypertension alone (aOR 2.10; 95% CI 1.12-3.94), obesity was associated with hypertension (aOR 5.04; 95% CI 2.80-9.06) as well as diabetes (aOR 5.28; 95% CI 2.25-12.3) and comorbidity (aOR 3.69; 95% CI 2.02-6.77). In whites and African-Americans, BMI and WC were positively related to diabetes, hypertension and comorbidity. In Hispanics, BMI and WC were also positively related to diabetes and comorbidity, but only the former measure was associated with hypertension (p < 0.050). In Asians, BMI was not a significant predictor of diabetes, hypertension and/or comorbidity. Collectively, the findings suggest that BMI is not universally informative and waist circumference and its derivatives may represent a viable, more racially/ethnically appropriate alternative for use with selected minority groups.

Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults

Background

Visceral adipose tissue (VAT) is a unique pathogenic fatty deposit, in that it is closely correlated with risk of cardiovascular diseases. The present study is to investigate the usefulness of neck circumference (NC) to indicate VAT.

Methods

Participants aged 35 to 75 years who had taken abdomen and neck computer tomography (CT) examination were included in this study. Neck adipose tissue, abdominal VAT and subcutaneous adipose tissue (SAT) areas, as well as sagittal abdominal diameter (SAD) were measured by CT. Body anthropometrics and metabolic parameters including blood glucose, lipid profiles and blood pressure were also measured.

Results

A lower abdomen CT examination was carried out on a total of 177 patients (87 male and 90 female) with a mean age of 59 years. Of the 177 participants, 15 men and 15 women also took a neck CT examination. With a comparable age and BMI, neck adipose area was correlated with abdominal VAT area significantly in men (r = 0.57, p = 0.028) and women (r = 0.53, p = 0.041). NC is positively correlated with VAT both in men (r = 0.49, p < 0.001) and women (r = 0.25, p = 0.012). Meanwhile, SAD is the best predictor for visceral fat both in men (r = 0.83, p < 0.001) and women (r = 0.73, p < 0.001). Body mass index (BMI), waist circumference (WC), and waist to height ratio (WHtR) correlated significantly with VAT both in men and women (r = 0.68, 0.42, 0.46 in men and 0.50, 0.23, 0.39 in women, p < 0.001), while waist hip ratio (WHR) displayed the weakest least correlation in men (r = 0.32, p = 0.001) and no correlation in women (r = 0.08, p = 0.442). Additionally, BMI was more strongly correlated with VAT than NC in both sexes (both p < 0.01).

Conclusion

Significant correlation between NC and VAT was present in Chinese men and women, which may be accounted by the fact that neck fat area is significantly correlated with abdominal VAT. Meanwhile, SAD is the best predictor for visceral fat in the Chinese population.

The effect of body fat distribution on ethnic differences in cardiometabolic risk factors of Chinese and Europeans

This study aimed to examine the differences in body fat distribution and cardiometabolic risk between individuals of Chinese and European origin and the role of body fat distribution on ethnic differences in cardiometabolic risk. A total of 418 participants from the Multicultural Community Health Assessment Trial were assessed for visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAT), anthropometric variables, blood pressure, and lipid, insulin, and glucose levels. Multiple regression analyses were split by sex and adjusted for appropriate covariates in model 1a and further adjusted for VAT in model 1b or SAT in model 1c. A secondary model replaced body mass index (BMI) with waist circumference (WC). Chinese males had higher levels of triglycerides, insulin, homeostasis model assessment, and SAT than European males, as well as higher total cholesterol (TC), glucose, and VAT in the model adjusted for WC. Chinese females had higher glucose levels than European females after adjustment for either BMI or WC. When VAT was added to the models, differences in cardiometabolic risk factors remained significant but were attenuated between Chinese and European males and females; SAT did not attenuate the ethnic difference in cardiometabolic risk. These findings suggest that the higher VAT levels seen in the Chinese population do not fully account for the ethnic disparities in these risk factors. Given the observed interethnic difference in body composition, current BMI and WC cutoffs might be misleading when it comes to identifying Chinese individuals at risk for type 2 diabetes or cardiovascular disease.