Waist-to-height ratio is a useful indicator of cardio-metabolic risk in South Africa

Utility of Obesity Indicators for Predicting Hypertension among Older Persons in Limpopo Province, South Africa

In view of the epidemic proportions of obesity in South Africa and its relationship to cardiometabolic diseases, such as hypertension, a cross sectional study was conducted to investigate the utility of obesity indicators for predicting hypertension among older persons (≥60 years, n = 350) in the Limpopo Province of South Africa. The WHO STEPwise approach was used to collect data on demographic and lifestyle factors. Anthropometrics and blood pressure were measured according to the standard procedures. Receiver operating characteristic curves (ROC) were used to investigate and compare the ability of obesity indicators to predict overall hypertension and either increased systolic (SBP) or increased diastolic (DBP) blood pressure. The area under the ROC curve (AUC) was used to assess a certain indicator’s potential to predict overall hypertension and either increased SBP or increased DBP. Multivariate logistic regression analysis was used to determine the relationship of hypertension with obesity indicators. The mean age of the participants was 69 years (±SD = 7), and hypertension (46%), general obesity (36%) and abdominal obesity (57%) were prevalent among older persons. The obesity indicator body mass index (BMI) (AUC = 0.603 (0.52; 0.69)) was the best predictor of hypertension in older men. Waist circumference (WC) (AUC = 0.640 (0.56; 0.72)) and waist-to-height ratio (WHtR) (AUC = 0.605 (0.52; 0.69)) were better predictors of hypertension than BMI and waist-to-hip ratio (WHR) in older women. After adjustment for risk factors, only WC (AOR = 1.22 (1.16; 1.79)) was significantly associated with hypertension in older women, proposing WC as a screening tool for the prediction of hypertension in South African older women.

Burden of Metabolic Syndrome Among a Low-Income Population in China: A Population-Based Cross-Sectional Study

INTRODUCTION

Metabolic syndrome (MetS) is a chronic and complex disease associated with all-cause mortality, cardiovascular disease, and type 2 diabetes. The present study aimed to evaluate the prevalence of MetS and its risk factors among middle-aged and older adults in low-income, low-education rural areas with a high incidence of stroke.

METHODS

This cross-sectional study of the general population was performed from April 2019 to June 2019 in rural areas of Tianjin, China. All eligible residents aged ≥ 45 years and without active malignant tumors, hepatic failure, and severe renal disease underwent routine medical examinations, which included a questionnaire, physical examination, and routine blood and biochemical tests. The modified International Diabetes Federation criteria for the Asian population was used to identify patients with MetS.

RESULTS

A total of 3175 individuals (44.8% men, 55.2% women) were included in the final analysis. The prevalence of MetS was 52.8%, with higher prevalence in women than in men (62.4%and 40.9%, respectively). Of the five MetS components, high blood pressure and abdominal obesity were the two most prevalent in both women and men, accounting for 89.3% and 62.0%, respectively, followed by elevated fasting plasma glucose, low high-density lipoprotein cholesterol, and elevated triglycerides. Multivariate logistic regression analysis revealed the following traits to be risk factors for MetS: female sex, self-reported smoking, self-reported snoring, high body mass index, high waist-to-hip ratio, and high serum urate level.

CONCLUSION

The prevalence of MetS was quite high in rural areas with a low-income, low-education population. Implementing preventive and therapeutic interventions based on these risk factors is essential to prevent metabolic abnormalities.

Relative children's lipid accumulation with hypertension in Chinese children and adolescents

Background

This study aimed to develop a novel indicator associated with hypertension in Chinese children and adolescents, the relative children’s lipid accumulation product (RCLAP).

Methods

A cross-sectional study was conducted in 2018. A total of 683 students aged 8–15 years were recruited via a stratified cluster sampling Methods. Anthropometric indexes (waist circumference (WC), Body mass index (BMI), Waist-height ratio (WHtR), logarithm children LAP (LnCLAP), RCLAP per height (RCLAP-H)) were standardized using a z-score method (standardized variables: SWC, SBMI, SWHtR, SLnCLAP, SRCLAP-H). A logistic regression model was performed to evaluate the association of the above indicators with the outcome of hypertension.

Results

The overall prevalence of hypertension was 5.7% (5.5% in boys, 6.0% in girls). SWC ≥ P₇₅, SBMI ≥ P₇₅, SWHtR ≥ P₇₅, SlnCLAP ≥ P₇₅ and SRCLAP-H ≥ P₇₅ significantly increased risk of hypertension, with odds ratios (OR) of 2.21 (95% confidence interval (CI): 1.13, 4.30), 2.30 (1.18, 4.49), 2.64 (1.35, 5.14), 4.43 (2.28, 8.61), and 4.49 (2.31, 8.71), respectively.

Conclusion

RCLAP is a novel indicator associated with hypertension in Chinese children and adolescents, and it performs better than WC, BMI, WHtR and children LAP.

Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults

Background

Metabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease. Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.

Methods

Cross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.

Results

After adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: − 0.227 for male, − 0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female’s high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.

Conclusions

AVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.