The performance of anthropometric measures to predict diabetes mellitus and hypertension among adults in Jordan

Associations between various anthropometric indices and hypertension and hyperlipidaemia: a cross-sectional study in China

BACKGROUND

This study aims to explore the association and determine the distinguished potential of anthropometric adiposity indices in screening for hypertension and hyperlipidaemia in the Chinese population.

METHODS

A recent nationwide cross-sectional study, called the Thyroid Disorders, Iodine State, and Diabetes Epidemiological Survey (TIDE 2015-2017), provided the newest data on the relationships between anthropometric adiposity indices and hypertension and hyperlipidaemia and included 65,231 subjects. The area under the curve (AUC) was used to assess the feasibility of using these indices to distinguish hypertension and hyperlipidaemia. After age stratification, a restricted cubic spline (RCS) fitted for generalized linear regression was used to visualize the relationships of the body mass index (BMI), waist circumference (WC), the waist-to-height ratio (WHtR), the body roundness index (BRI), and the "a body shape index" (ABSI) with hypertension and hyperlipidaemia.

RESULTS

The results showed that there were significant differences in the BMI, WC, the WHtR, the BRI, and the ABSI among the different age groups (P < 0.0001). After adjusting for sex, age, education, income, smoking status, urban or rural residence, and ethnicity in model, The WHtR and BRI had greater discriminatory power in identifying hypertension (AUC = 0.665, 95% confidence interval (CI) 0.660-0.671 for both), hypercholesterolaemia (AUC = 0.629, 95% CI 0.624-0.634 for both), and high low-density lipoprotein cholesterol (LDL-C; AUC = 0.659, 95% CI 0.653-0.664 for both) status in the overall population. When distinguishing hypertriglyceridaemia among the general population, the BMI (AUC = 0.711, 95% CI 0.706-0.716) and WC (AUC = 0.715, 95% CI 0.710-0.720) had greater discriminatory ability than the other anthropometric indices did. The BMI (AUC = 0.631, 95% CI 0.625-0.637) had the highest power for low high-density lipoprotein cholesterol (HDL-C) status in the general population.

CONCLUSIONS

Several anthropometric indices show significant correlation with hypertension and hyperlipidaemia. The WHtR and BRI were better in distinguishing hypertension, hypercholesterolaemia and high LDL-C status, while the BMI was better in hypertriglyceridaemia and low HDL-C status. The use of combined indices, such as the BMI, WC, the WHtR and the BRI, can be included in an individual's medical history and can be used as tools for cardiovascular health screening, which may yield superior results for public health.

Evaluating the Association of Anthropometric Indices With Total Cholesterol in a Large Population Using Data Mining Algorithms

BACKGROUND

Unbalanced levels of serum total cholesterol (TC) and its subgroups are called dyslipidemia. Several anthropometric indices have been developed to provide a more accurate assessment of body shape and the health risks associated with obesity. In this study, we used the random forest model (RF), decision tree (DT), and logistic regression (LR) to predict total cholesterol based on new anthropometric indices in a sex-stratified analysis.

METHOD

Our sample size was 9639 people in which anthropometric parameters were measured for the participants and data regarding the demographic and laboratory data were obtained. Aiding the machine learning, DT, LR, and RF were drawn to build a measurement prediction model.

RESULTS

Anthropometric and other related variables were compared between both TC <200 and TC ≥200 groups. In both males and females, Lipid Accumulation Product (LAP) had the greatest effect on the risk of TC increase. According to results of the RF model, LAP and Visceral Adiposity Index (VAI) were significant variables for men. VAI also had a stronger correlation with HDL-C and triglyceride. We identified specific anthropometric thresholds based on DT analysis that could be used to classify individuals at high or low risk of elevated TC levels. The RF model determined that the most important variables for both genders were VAI and LAP.

CONCLUSION

We tend to present a picture of the Persian population's anthropometric factors and their association with TC level and possible risk factors. Various anthropometric indices indicated different predictive power for TC levels in the Persian population.

The association between dietary inflammatory index with some cardio-metabolic risk indices among the patients with type 2 diabetes from Hoveyzeh cohort study: a cross-sectional study

BACKGROUND

The dietary inflammatory index (DII) serves as a tool to assess the inflammatory impact of an individual's diet. This study aimed to investigate the association between DII and some cardio-metabolic risk indices among patients with T2DM.

METHODS

Data from the Hoveyzeh Cohort Study, encompassing 2045 adults with T2DM, were analyzed. DII scores were calculated based on food frequency questionnaires. Anthropometric measurements and biochemical tests were performed to assess cardio-metabolic risk factors.

RESULTS

Higher DII scores were positively associated with elevated triglyceride levels, triglyceride-glucose (TyG) index, lipid accumulation product (LAP), anthropometric indices including a body shape index (ABSI), body roundness index (BRI), body mass index (BMI), hip, waist circumferences (WC), and waist-to-height ratio (all Ptrend < 0.05). Notably, no significant association was observed between DII and fasting blood sugar (FBS) levels (Ptrend > 0.05). Additionally, dietary intake analysis revealed a negative correlation between DII scores and intake of fiber, fruits, vegetables, legumes, fish, seafood, dairy products, magnesium, and vitamins A, C, D, and E (all Ptrend < 0.05). Conversely, higher DII scores were associated with increased consumption of red meat, processed meat, refined cereals, potatoes, and soft drinks (all Ptrend < 0.05).

CONCLUSION

This study underscores the critical link between dietary inflammation, assessed by the DII score, and a multitude of cardio-metabolic risk factors in patients with T2DM. Notably, while the study did not find a significant association between DII and fasting blood sugar levels, it identified robust associations with novel anthropometric and biochemical indices indicative of cardio-metabolic risk. These findings highlight the potential of dietary interventions as a cornerstone strategy for managing T2DM and mitigating its associated complications.

Anthropometric indexes for predicting high blood pressure in Turkish adults

Purpose

It is controversial which anthropometric indexes are the best in predicting the risk of hypertension and how anthropometric measurements are related to blood pressure (BP). This study aimed to evaluate the relationship between BP and anthropometric indexes and to determine the best predictors for hypertension risk.

Methods

This cross-sectional study was conducted with 415 consecutive participants (161 men, mean age: 33.4 years) aged 18-88 years in Istanbul, Turkey. Weight, height, waist circumference (WC), and neck circumference (NC) and BP were measured by well-trained personnel. Waist-to-height ratio (WHtR) and body mass index (BMI) were calculated. Pearson correlation, linear regression, and multivariate analyses were used to assess the relationship between anthropometric measurements and SBP, DBP, using the Statistical Package for the Social Sciences version 23.0.

Results

The systolic BP (SBP) and diastolic BP (DBP) were related to weight, WC, NC, BMI, and WHtR (P < 0.05). Linear regression analyses showed BMI and WC as independent risk factors for SBP with an increase by 1.11 mmHg in men (P = 0.036) and 1.59 mmHg in women (P = 0.001) in SBP when BMI increased 1 unit, while SBP increases by 0.2 mmHg when WC increases by 1 unit regardless of gender (P = 0.013).

Conclusion

Our results showed that BMI and WC are related to BP and important predictors of hypertension risk. Therefore, the uses of BMI and WC are recommended as screening tools for the prediction of hypertension risk among Turkish adults.

A New Approach Using BMI and FMI as Predictors of Cardio-Vascular Risk Factors among Mexican Young Adults

The study aimed to identify accurate cut-off points for waist circumference (WC), body fat percentage (BF%), body mass index (BMI), fat mass index (FMI), and fat-free mass index (FFMI), and to determine their effective accuracy to predict cardiovascular risk factors (CVRFs) among Mexican young adults. A cross-sectional study was conducted among 1730 Mexican young adults. Adiposity measures and CVRFs were assessed under fasting conditions. The optimal cut-off points were assessed using the receiver operating characteristic curve (ROC). Age-adjusted odds ratios (OR) were used to assess the associations between anthropometric measurements and CVRFs. The cut-off values found, in females and males, respectively, for high WC (≥72.3 and ≥84.9), high BF% (≥30 and ≥22.6), high BMI (≥23.7 and ≥24.4), high FMI (≥7.1 and ≥5.5), and low FFMI (≤16 and ≤18.9) differ from those set by current guidelines. High BMI in women, and high FMI in men, assessed by the 50th percentile, had the best discriminatory power in detecting CVRFs, especially high triglycerides (OR: 3.07, CI: 2.21-4.27 and OR: 3.05, CI: 2.28-4.08, respectively). Therefore, these results suggest that BMI and FMI measures should be used to improve the screening of CVRFs in Mexican young adults.

Association of the Clínica Universidad de Navarra-Body Adiposity Estimator With Type 2 Diabetes: A Retrospective Cohort Study

Objectives: Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) is considered to be a more accurate indicator of body fat estimation. We aimed to investigate the association of CUN-BAE with the risk of type 2 diabetes mellitus (T2DM) and to compare the strength of the association between CUN-BAE, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and T2DM. Methods: The data were obtained from the annual health checkup database of residents in Xinzheng, China. From January 2011 to December 2021, 80,555 subjects aged ≥45 years met the inclusion criteria. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in T2DM. Results: During a mean follow-up of 6.26 years, T2DM occurred in 12,967 subjects. The multivariable-adjusted HRs (95% CIs) of T2DM (highest vs. reference group) were 1.994 (1.811-2.196) for CUN-BAE, 1.751 (1.665-1.842) for WC, 1.715 (1.631-1.804) for WHtR, and 1.510 (1.436-1.588) for BMI, respectively. In addition, the risk of T2DM increased with baseline CUN-BAE (HR: 1.374; 95% CI: 1.328, 1.421), WC (HR: 1.236; 95% CI: 1.215, 1.256), WHtR (HR: 1.228; 95% CI: 1.208, 1.248), and BMI (HR: 1.175; 95% CI: 1.156, 1.195). Conclusion: Compared to BMI, WC or WHtR, CUN-BAE may more adequately reflect the adverse effects of adiposity on the risk of T2DM.

Assessing Individuals Attending the Family Medicine Clinic for Periodic Health Examinations in Screening of Diabetes Mellitus

PURPOSE

This study aims to evaluate the presence and risk of diabetes mellitus (DM) and the factors affecting the risk in those who visited the family medicine outpatient clinic.

METHODS

The present study included adult patients who presented to the outpatient clinic for periodic health examination between February 4, 2022, and April 4, 2022, and who had no known history of DM and were eligible for screening. Anthropometric measurements of the participants were made and their clinical and familial histories were taken in relation to DM. HbA1c and fasting blood glucose (FBG) tests were conducted for each participant.

RESULTS

A total of 125 participants, 87 (69.6%) women and 38 (30.4%) men, were included in the study, and five (4%) participants had diabetes. The analysis of the independent risk factors associated with diabetes by multivariate logistic regression analysis revealed that the presence of DM in the family increased the risk of having HbA1c ≥ 5.7% (OR: 3.441; 95% CI: 1.381-8,574; p=0.008). Among women, the waist circumference being > 95 cm was determined as a discriminating factor for HbA1c ≥ 5.7% (sensitivity: 61.54% and specificity: 68.85%).

CONCLUSION

Accurate patient-centered risk assessments by family physicians can lead to positive lifestyle modifications in patients. For this purpose, family physicians should evaluate the patients for diabetes and its associated risk factors and encourage them to take measures in order to prevent diabetes.

Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults

Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37-39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37-39 years. For FMI (kg/m2), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37-39 years. The BMI cut-off points (kg/m2) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37-39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.

Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia (BPH). Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital, Central South University (Changsha, China) from June to December 2020 were enrolled in this study. The characteristic data were collected, including basic anthropometric indices, lipid parameters, six anthropometric indicators, prostate-specific antigen, and total prostate volume. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for all anthropometric parameters and BPH were calculated using binary logistic regression. To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values, receiver operating characteristic (ROC) curves and the related areas under the curves (AUCs) were utilized. All six indicators had diagnostic value for BPH (all P ≤ 0.001). The visceral adiposity index (VAI; AUC: 0.797, 95% CI: 0.759-0.834) had the highest AUC and therefore the highest diagnostic value. This was followed by the cardiometabolic index (CMI; AUC: 0.792, 95% CI: 0.753-0.831), lipid accumulation product (LAP; AUC: 0.766, 95% CI: 0.723-0.809), waist-to-hip ratio (WHR; AUC: 0.660, 95% CI: 0.609-0.712), waist-to-height ratio (WHtR; AUC: 0.639, 95% CI: 0.587-0.691), and body mass index (BMI; AUC: 0.592, 95% CI: 0.540-0.643). The sensitivity of CMI was the highest (92.1%), and WHtR had the highest specificity of 94.1%. CMI consistently showed the highest OR in the binary logistic regression analysis. BMI, WHtR, WHR, VAI, CMI, and LAP all influence the occurrence of BPH in middle-aged and older men (all P ≤ 0.001), and CMI is the best predictor of BPH.

Detection of high risk people for diabetes by American diabetes association risk score in PERSIAN Guilan cohort study

BACKGROUND

Diabetes mellitus (DM) is known as one of the most prevalent non communicable diseases with high cost of health services in the world. Present study was conducted to assess the frequency of high risk people for diabetes mellitus based on American Diabetes Association (ADA) risk score among Iranian people.

METHODS

Present study was a cross sectional study on non-diabetic subjects aged 35-70 years from 10,520 PERSIAN Guilan Cohort Study (PGCS). ADA risk score was calculated for every individual through an online calculator. Receiver operating characteristic (ROC) curves was used to assess diagnostic accuracy of the anthropometric indices to identify individuals with high risk ADA score for developing DM, represented by the area under the curve (AUC).

RESULTS

From 7989 study subjects, ADA risk score found 3874 (48.5%) and 1912 (23%) at risk for developing PreDM and DM, respectively. The results of ROC curve analyses showed the highest diagnostic value was related to waist circumference (WC) in total population and Waist to Height Ratio in both sex (0.695 total, 0.743 female, 0.744 male). The cut-points of WC in total population to identifying high risk group were 97 cm.

CONCLUSIONS

A considerable number of populations were classified as high ADA risk for developing DM and PreDM that provide the importance of prevention strategies. Present study showed WC and Waist to Height Ratio have the highest diagnostic value to identify high risk people for DM.

Can anthropometric indices predict the chance of hypertension? A multicentre cross-sectional study in Iran

OBJECTIVES

This study aims to assess the prevalence of hypertension (HTN), and determine the relationship between HTN and anthropometric indices including fat distribution, body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in Shiraz Heart Study.

SETTING

In this cross-sectional study, subjects were enrolled in 25 clinics in Shiraz. I.R. Iran between 2019 and 2021.

PARTICIPANTS

A total number of 7225 individuals were selected, aged between 40 and 70 years of whom 52.3% were female. Among the people living in Shiraz, individuals living far from clinics, cases of mental or physical disabilitiy and documented cardiovascular diseases were excluded.

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary outcome: The association of body composition, WHR, WHtR and BMI with HTN.

SECONDARY OUTCOME

The sensitivity and specificity of the WHtR for the prediction of HTN.

RESULTS

HTN prevalence was 19.3%. Obesity prevalence was estimated to be 28.5%. WHR and lean body mass showed a significant association with HTN (p<0.05). Receiver operating characteristic for WHtR yielded an area under the curve of 0.62 (95% CI 0.61 to 0.64) and 0.63 (95% CI 0.62 to 0.65) for males and females, respectively. The optimal threshold value yielded 0.54 in men and 0.61 in women. The sensitivity was 72.3% and 73.9% in women and men, with specificity of 48.4% and 44.3%, respectively.

CONCLUSION

HTN had a meaningful association with all the noted anthropometric indices. WHtR performed well as a predictor of HTN.

Cut-off points for anthropometric indices to screen for hypertension among Iranian adults of the Bandare-Kong cohort: a cross-sectional study

Background

Obesity is one of the major determinants of blood pressure. This study aimed to determine the optimal sex- and age-specific cut-off points of anthropometric indices, including body mass index (BMI), waist circumference (WC), hip circumference (HC), wrist circumference (WrC), waist-hip ratio (WHR), and waist-height ratio (WHtR), to screen for hypertension (HTN) in a cohort of Iranian adults aged 35 to 70 years, and to compare the predictive performance of the indices based on receiver operating characteristic (ROC) curves.

Methods

This population-based study was carried out on the participants aged 35 to 70 years of the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Using the area under the receiver operating characteristic curve (AUC) and Youden's J index, optimal sex- and age-specific cut-off points of the anthropometric indices in association with HTN were calculated.

Results

This study included a total of 2256 females and 1722 males. HTN was diagnosed in 736 females (32.6%) and 544 males (31.6%). The optimal cut-off of WC for HTN was 90 cm in males and 95 cm in females, with an area under the ROC curve (AUROC) of 0.60 and 0.64, respectively. For HC, the optimal cut-off was 95 cm for males and 108 cm for females (AUROC = 0.54 for both). Moreover, WrC optimal cut-offs were 17 cm for males (AUROC = 0.56) and 15 cm for females (AUROC = 0.57). As for BMI, the optimal cut-off was 25 kg/m² in males and 27 kg/m² in females (AUROC of 0.59 and 0.60, respectively). Also, a cut-off of 0.92 was optimal for WHR in males (AUROC = 0.64) and 0.96 in females (AUROC = 0.67). On the other hand, WHtR optimal cut-offs were 0.52 for males and 0.60 for females (AUROC of 0.63 and 0.65, respectively).

Conclusions

WHR and WHtR, as anthropometric indices of obesity, were demonstrated to be significant predictors of HTN. Further, we suggest using WHR (cut-off point of 0.92 for males and 0.96 for females) and WHtR (cut-off point of 0.52 for males and 0.60 for females) as measures of preference to predict HTN among the southern Iranian population. Further multicenter longitudinal studies are recommended for a more accurate prediction of HTN.

Relationship between anthropometric indices and arterial stiffness: Insights from an epidemiologic study

Background

Obesity and arteriosclerosis are both independently associated with cardiovascular disease risk. Obesity also may increase arterial stiffness.

Aims

This study aimed to investigate the association between anthropometric indices and non-invasive arterial stiffness parameters, using data from a large population-based cohort of seemingly healthy women and men.

Methods

A total of 5023 eligible participants were included in the study. The pulse wave velocity (PWV), central blood pressures, and bio-impedance measures were obtained at the time of enrollment. Multiple regression analysis was performed to assess the relationship between anthropometric indices with arterial stiffness parameters.

Results

The mean age of participants was 45.3 ± 8.8 years, 2368 (47.1%) were males and 2655 (52.8%) were females. The prevalence of participant with underweight, normal weight, overweight, and obesity were 0.73%, 33.2%, 48.7%, and 17.2% respectively. Systolic and diastolic blood pressure, fatty liver, and hypertension were significantly higher in overweight/obesity participants. The overweight/obesity participants had significantly higher PWV than the normal-weight group (471.5 ± 42.6/496.7 ± 47.5 cm/s vs. 448.1 ± 41.4 cm/s, p < 0.001).

Conclusion

The prevalence of diabetes, hypertension, fatty liver disease, chronic lung disease, and also kidney stones were significantly higher in overweight and individuals with obesity. Body mass index, body fat mass, waist-hip ratio abdominal circumference, neck circumference, visceral fat area, total body water, 50-kHz whole body phase angle are positively correlated with PWV. Augmentation index had no significant correlation with body mass index, arm, hip, and abdominal circumferences.

Cost-effectiveness of community diabetes screening: Application of Akaike information criterion in rural communities of Nigeria

Background

The prevalence of diabetes mellitus (DM) is increasing globally, and this requires several approaches to screening. There are reports of alternative indices for prediction of DM, besides fasting blood glucose (FBG) level. This study, investigated the ability of combination of biochemical and anthropometric parameters and orodental disease indicators (ODIs) to generate models for DM prediction, using Akaike information criterion (AIC) to substantiate health economics of diabetes screening.

Methods

Four hundred and thirty-three subjects were enrolled in the study in Ndokwa communities, Delta State, Nigeria, and their glycaemic status was determined, using the CardioChek analyser^® and previous data from the Prediabetes and Cardiovascular Complications Study were also used. The cost of screening for diabetes (NGN 300 = $0.72) in a not-for-profit organization/hospital was used as basis to calculate the health economics of number of individuals with DM in 1,000 participants. Data on the subjects' anthropometric, biochemical and ODI parameters were used to generate different models, using R statistical software (version 4.0.0). The different models were evaluated for their AIC values. Lowest AIC was considered as best model. Microsoft Excel software (version 2020) was used in preliminary analysis.

Result

The cost of identifying <2 new subjects with hyperglycemia, in 1,000 people was ≥NGN 300,000 ($ 716). A total of 4,125 models were generated. AIC modeling indicates FBG test as the best model (AIC = 4), and the least being combination of random blood sugar + waist circumference + hip circumference (AIC ≈ 34). Models containing ODI parameters had AIC values >34, hence considered as not recommendable.

Conclusion

The cost of general screening for diabetes in rural communities may appear high and burdensome in terms of health economics. However, the use of prediction models involving AIC is of value in terms of cost-benefit and cost-effectiveness to the healthcare consumers, which favors health economics.

High prevalence of diabetes in elderly of Iran: an urgent public health issue

Purpose

To determine the distribution of blood glucose and prevalence of diabetes in people above 60 years living in Tehran and their relationship with some variables.

Methods

In this cross-sectional population-based study, multistage cluster sampling was performed in the over 60-year-old population of Tehran. Blood samples were collected from all participants and the data of the history of diabetes and the use of blood glucose lowering agents or other drugs were collected using interviews.

Results

Of 3791 selected subjects, 3310 participated in the study (response rate = 87.3%). The mean blood Sugar (BS) and hemoglobin A1c (HbA1c) of the patients was 118.11(95% CI: 115.34 -120.88) and 6.12(95% CI: 6.05-6.2) respectively. The prevalence of diabetes was 29.03%(95% CI: 27.12-30.94) in all subjects, 26.83%(95% CI: 24.58-29.07) in men, and 31.2%(95% CI: 28.24-34.16) in women. Odds of diabetes was significantly worse in women. systolic blood pressure, diasstolic blood pressure, height, weight, waist circumference, wrist circumference, hip circumference, neck circumference and body mass Index were significantly higher in diabetic after adjusting for the effect of sex and age. The odds of blindness was 2.69 (95% CI: 1.10-6.59) times higher in diabetic than in non-diabetics.

Conclusions

On average, one in every three persons above 60 years of age was diabetic. Therefore, attention should be paid to this age group, especially women, due the higher prevalence of diabetes. All anthropometric measurements except height had a strong correlation with diabetes. Blindness was significantly more in diabetics.

Evaluation of anthropometric indices as a predictor of diabetes in Dong and Miao ethnicities in China: A cross-sectional analysis of China Multi-Ethnic Cohort Study

BACKGROUND

Although it is known that obesity is inseparable from diabetes, many anthropometric indices are used for determining obesity. At the same time, research on the predictive indices of diabetes in Chinese minority populations is lacking. Therefore, this study determines the relationship between different anthropometric indices and diabetes, and identifies the best index and best cut-off values for predicting diabetes.

METHOD

In total, 11,035 Dong and Miao ethnic participants (age: 30-79 years) from the China Multi-Ethnic Cohort study were included. The logistic regression model was used to examine the relationship between the different anthropometric indices and diabetes risk. The receiver operating characteristic curve and the area under the curve (AUC) were used to identify the best predictor of diabetes.

RESULTS

In multivariate adjusted logistic regression models, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and visceral adiposity index (VAI) were positively correlated with diabetes risk. Among Chinese Dong men and women and Miao men, WHR had the largest AUC (0.654/0.719/0.651). Among Miao women, VAI had the largest AUC(0.701). The best cut-off values of WHR for Dong men and women and Miao men were 0.94, 0.92, and 0.91, respectively. The best cut-off value of VAI for Miao women was 2.20.

CONCLUSION

Obesity indicators better predict diabetes in women than men. WHR may be the best predictor of diabetes risk in both sex of Dong ethnicity and Miao men, and VAI may be the best predictor of diabetes risk in Miao women.

Anthropometric cut-points for discriminating diabetes and the metabolic syndrome among Arabs and Asians: the Kuwait Diabetes Epidemiology Program

This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18-60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.

Stronger Associations of Body Mass Index and Waist Circumference with Diabetes than Waist-Height Ratio and Triglyceride Glucose Index in the Middle-Aged and Elderly Population: A Retrospective Cohort Study

BACKGROUND

It remains controversial whether body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), or triglyceride glucose (TyG) index has a stronger association with diabetes. The aims of the study were to compare the magnitude of associations of four indicators with diabetes risk.

METHODS

Data collected from annual health examination dataset in the Xinzheng during 2011 and 2019. A total of 41,242 participants aged ≥ 45 years were included in this study. Cox proportional hazard regression models were used to examine associations between the four indicators and diabetes risk.

RESULTS

After 205,770 person-years of follow up, diabetes developed in 2,472 subjects. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of diabetes (highest vs reference group) were 1.92 (1.71-2.16) for BMI, 1.99 (1.78-2.23) for WC, 1.65 (1.47-1.86) for WHtR, and 1.66 (1.47-1.87) for TyG, respectively. In addition, the risk of diabetes increased with baseline BMI (HR: 1.30; 95% CI: 1.25, 1.35) and TyG (HR: 1.25; 95% CI: 1.20, 1.30), but the lowest HR was 0.78 (95% CI 0.65-0.92) when WC was approximately 72 cm, and 0.85 (95% CI 0.72-0.99) when WHtR was approximately 0.47 in women. In joint analyses, the highest risk was observed in participants with a high BMI combined with a high WC (HR: 2.26; 95% CI: 1.98, 2.58).

CONCLUSIONS

In middle-aged and elderly Chinese population, BMI and WC were more strongly associated with diabetes than WHtR or TyG, especially the combined effect of BMI and WC.

A Multilayer Perceptron Neural Network Model to Classify Hypertension in Adolescents Using Anthropometric Measurements: A Cross-Sectional Study in Sarawak, Malaysia

This study outlines and developed a multilayer perceptron (MLP) neural network model for adolescent hypertension classification focusing on the use of simple anthropometric and sociodemographic data collected from a cross-sectional research study in Sarawak, Malaysia. Among the 2,461 data collected, 741 were hypertensive (30.1%) and 1720 were normal (69.9%). During the data gathering process, eleven anthropometric measurements and sociodemographic data were collected. The variable selection procedure in the methodology proposed selected five parameters: weight, weight-to-height ratio (WHtR), age, sex, and ethnicity, as the input of the network model. The developed MLP model with a single hidden layer of 50 hidden neurons managed to achieve a sensitivity of 0.41, specificity of 0.91, precision of 0.65, F-score of 0.50, accuracy of 0.76, and Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.75 using the imbalanced data set. Analyzing the performance metrics obtained from the training, validation and testing data sets show that the developed network model is well-generalized. Using Bayes' Theorem, an adolescent classified as hypertensive using this created model has a 66.2% likelihood of having hypertension in the Sarawak adolescent population, which has a hypertension prevalence of 30.1%. When the prevalence of hypertension in the Sarawak population was increased to 50%, the developed model could predict an adolescent having hypertension with an 82.0% chance, whereas when the prevalence of hypertension was reduced to 10%, the developed model could only predict true positive hypertension with a 33.6% chance. With the sensitivity of the model increasing to 65% and 90% while retaining a specificity of 91%, the true positivity of an adolescent being hypertension would be 75.7% and 81.2%, respectively, according to Bayes' Theorem. The findings show that simple anthropometric measurements paired with sociodemographic data are feasible to be used to classify hypertension in adolescents using the developed MLP model in Sarawak adolescent population with modest hypertension prevalence. However, a model with higher sensitivity and specificity is required for better positive hypertension predictive value when the prevalence is low. We conclude that the developed classification model could serve as a quick and easy preliminary warning tool for screening high-risk adolescents of developing hypertension.

Waist-To-Height Ratio Is a More Accurate Tool for Predicting Hypertension Than Waist-To-Hip Circumference and BMI in Patients With Type 2 Diabetes: A Prospective Study

Background: Anthropometric measures [i.e., body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)] have been used as prediction factors for incident hypertension. However, whether any of these measures is superior to another in the matter of accuracy in predicting hypertension in diabetic patients has been controversial. The present prospective study aimed to determine whether WHtR is a more accurate tool for predicting hypertension than WHR and BMI in patients with type 2 diabetes.

Methods: The study population consisted of 1,685 normotensive patients with type 2 diabetes. BMI, WHR, and WHtR were assessed at baseline and followed up for hypertension incidence for a mean of 4.8 years. A cox regression analysis was performed to assess the association between anthropometric measures (i.e., BMI, WHR, and WHtR) and incident hypertension during the follow-up period. The area under the ROC curve analysis was performed and optimal cutoff values were calculated for each anthropometric measure for hypertension prediction.

Results: WHtR and BMI were significantly associated with an increased incidence of hypertension (HR = 3.296 (0.936–12.857), P < 0.001, and HR = 1.050 (1.030–1.070), P < 0.001, respectively). The discriminative powers for each anthropometric index for hypertension were 0.571 (0.540–0.602) for BMI, 0.518 (0.486–0.550) for WHR, and 0.609 (0.578–0.639) for WHtR. The optimal cutoff points for predicting hypertension in patients with type 2 diabetes were 26.94 (sensitivity = 0.739, specificity = 0.380) for BMI, 0.90 (sensitivity = 0.718, specificity = 0.279) for WHR, and 0.59 (sensitivity = 0.676, specificity = 0.517) for WHtR.

Conclusion: WHtR was a more accurate tool for predicting hypertension compared to WHR and BMI in patients with type 2 diabetes.

Comparison of Body Mass Index and Waist Circumference in the Prediction of Diabetes: A Retrospective Longitudinal Study

INTRODUCTION

Both body mass index (BMI) and waist circumference (WC) are associated with diabetes risk, and the difference between them in predictive ability for diabetes is still contentious. We conducted a population-based study to investigate and compare the association of them with diabetes by sex.

METHODS

This study included a total of 4754 subjects aged 40-80 years with no diabetes at baseline between 2008 and 2017. Using multivariate Cox proportional hazards models, we calculated hazard ratios for diabetes according to tertiles of BMI or WC. Harrell's C statistics was applied to assess and compare the predictive ability of the models using BMI and WC.

RESULTS

Both BMI and WC showed the significant positive trends with diabetes risk. In men, the extreme tertiles (BMI > 25.1 kg/m² and WC > 88.0 cm) provided 1.58-fold or 2.04-fold higher risk compared with the first tertiles (< 22.6 kg/m² and < 81.2 cm). In women, BMI > 24.4 kg/m² showed 3.28-fold higher risk than the first tertile (< 21.6 kg/m²), whereas WC ≥ 78.2 cm was more than twice as likely to suffer from diabetes as WC < 78.2 cm. BMI and WC showed a comparative performance in predicting diabetes in both sexes (P value 0.447 in men, and 0.337 in women).

CONCLUSION

Both BMI and WC showed a positive association with diabetes and offered a comparative predictive performance for diabetes in both sexes. The cut-off points, BMI 25.1 kg/m² and WC 88.0 cm in men and BMI 24.4 kg/m² and WC 78.2 cm in women, might contribute to the effective prevention strategies for diabetes.

Relationship of Anthropometric Indicators of General and Abdominal Obesity with Hypertension and Their Predictive Performance among Albanians: A Nationwide Cross-Sectional Study

Anthropometric indicators of general and abdominal obesity can predict cardiovascular disease outcomes. Their performance in predicting hypertension (HTN) varies across populations. We aimed to analyze the relationship of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (CI) with HTN, to examine their predictive performance and to determine their optimal cut-offs in a nationally representative sample of Albanians aged 15-59 years (n = 20,635). Logistic regression models were fitted and sex-specific receiver-operating characteristic (ROC) curves were constructed. The indicators were positively associated with HTN. Sex modified the relationships, as associations appeared significantly stronger among females than males in the highest categories of the indicators. The area under ROC curves (AUCs) for BMI were 0.729 (95% confidence interval (CI): 0.720-0.738) among females and 0.648 (95% CI: 0.633-0.663) among males, and AUCs for WHtR were 0.725 (95% CI: 0.716-0.734) among females and 0.637 (95% CI: 0.622-0.652) among males. However, the AUCs for BMI and WHtR did not differ significantly among females (p = 0.279) and males (p = 0.227). BMI outperformed WC and CI in both sexes. The optimal BMI cut-offs were 27.0 kg/m² among females and 25.6 kg/m² among males, and that for WHtR were 0.53 among females and 0.54 among males. BMI and WHtR demonstrated similar discriminatory power, and the identified cut-offs may inform initiatives for structured HTN screening in Albania.

The effect of obesity on periodontitis progression: the 10-year retrospective cohort study

OBJECTIVE

Due to inconsistent findings in limited previous cohort studies, the aim of this study was to estimate the obesity effect on periodontitis progression in Thai adults.

MATERIALS AND METHODS

This 10-year retrospective cohort study comprised 2216 employees of the Electric Generation Authority of Thailand (EGAT). Their demographic, medical, and periodontal status was collected. Subjects with periodontitis progression were defined as having ≥ 2 teeth with progression. Additional proximal clinical attachment loss ≥ 3 mm or tooth loss with severe periodontitis at baseline were used to identify disease progression at the tooth level. Central obesity was classified using the waist-hip ratio. Multi-level Poisson regression was used to determine the effect of obesity on periodontitis progression by adjusting for age, sex, education, income, smoking, alcohol drinking, exercise, diabetes mellitus, and hypertension.

RESULTS

The cumulative incidence of periodontitis progression during the 10-year period was 59.6 cases per 100 persons (95% CI: 57.5, 61.6). The univariate analysis indicated that obese subjects had 15% higher risk of progression than that of healthy subjects. However, when confounders were analyzed simultaneously, the effect of obesity was not significant with a risk ratio of 0.98 (95% CI: 0.88, 1.08).

CONCLUSIONS

Despite the higher incidence of disease progression in the obese, obesity is not an independent risk factor for periodontitis progression.

CLINICAL RELEVANCE

Obesity and periodontitis progression share many common risk factors. Using the obesity as a preliminary screening for periodontitis progression may be an alternative prevention protocol.

The Influence of Anthropometric Indices and Intermediary Determinants of Hypertension in Bangladesh

Hypertension is a major public health burden in Bangladesh. However, studies considering the underlying multifaceted risk factors of this health condition are sparse. The present study concurrently examines anthropometric parameters and intermediary factors influencing hypertension risk in Bangladesh. Using the 2018 World Health Organisation (WHO) STEPwise approach to non-communicable disease risk factor surveillance (STEPS) study conducted in Bangladesh and involving 8019 nationally representative adult respondents, bivariate and multivariate logistic regression analyses were performed to determine the association between anthropometrics, other intermediary factors and hypertension. The regression results were presented using the odds ratio (OR) and adjusted odds ratio (AOR) at 95% confidence intervals (CIs). The risk of hypertension was higher among females and males who were 40 years and older. However, among females, those who were age 60 years and older were more than twice and thrice more likely to be hypertensive compared to those in the younger age groups (18–39, 40–59). Females who were obese (body mass index [BMI], waist to hip ratio [WHR], waist to height ratio [WHtR]) or had high waist circumference [WC] were twice as likely to be hypertensive. Males and females who were physically active, consuming more fruits and vegetables daily and educated had lower odds of developing hypertension. Key findings suggest that the association between anthropometric indices (body mass index [BMI], waist to hip ratio [WHR], waist to height ratio [WHtR]), waist circumference [WC]), other intermediary determinants (e.g., education, physical activity) and hypertension exist across gender and with increasing age among adults in Bangladesh. Developing appropriate public health interventions (e.g., regular assessment of anthropometric parameters) for early identification of the risk and pattern of hypertension through appropriate screening and diagnosis is required to meet the specific health needs of the adult Bangladesh population.

Association of body mass index and waist circumference with high blood pressure in older adults

BACKGROUND

The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure.

METHODS

We examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure.

RESULTS

The full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m² in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080-1.087) and 1.026(1.024-1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m² and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced.

CONCLUSION

These findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.

Faktor yang Berhubungan dengan Konsumsi Energi Ibu Menyusui di Kecamatan Cipayung, Kota Depok, Indonesia

Latar Belakang: Untuk mendukung kebutuhan gizi yang tinggi saat menyusui, ibu menyusui membutuhkan lebih banyak energi dibandingkan ibu hamil. Namun, berbagai studi melaporkan bahwa konsumsi energi ibu menyusui justru lebih rendah dibandingkan ibu hamil.Tujuan: Mengetahui faktor yang berhubungan dengan konsumsi energi ibu menyusui yang rendah di Kecamatan Cipayung Kota Depok Tahun 2016.Metode: Penelitian ini menganalisis data sekunder dari penelitian eksperimental semu dengan pendekatan kohort prospektif di Kota Depok. Total sampel berjumlah 169 responden. Analisis data pada penelitian ini menggunakan uji chi-square dan uji regresi logistik ganda.Hasil:  Konsumsi energi ibu saat hamil merupakan faktor dominan yang berhubungan dengan konsumsi energi ibu saat menyusui setelah dikontrol dengan paritas dan usia ibu. Ibu yang mengonsumsi energi dalam jumlah kurang saat hamil berisiko 3,5 kali lebih besar untuk mengonsumsi energi dalam jumlah kurang saat menyusui.Kesimpulan: Konsumsi energi ibu hamil sangat penting diperhatikan karena selain diperlukan untuk pertumbuhan dan perkembangan janin, sebagai cadangan lemak yang akan digunakan saat menyusui, juga untuk menjamin agar ibu mengonsumsi energi dalam jumlah cukup saat menyusui. 

Body roundness index is a superior indicator to associate with the cardio-metabolic risk: evidence from a cross-sectional study with 17,000 Eastern-China adults

Background

To investigate the ability of body shape index (ABSI), body roundness index (BRI), waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body adiposity index (BAI) for predicting non-adipose cardio-metabolic risk.

Methods

A total of 17,360 Chinese subjects aged 18–95 years old who escaped cardiovascular disease (CVD) or diabetes were recruited in the cross-sectional study. Anthropometric and biochemical parameters were assessed. Receiver operating characteristic curve (ROC) and multinomial logistic regression were conducted to examine the association of anthropometric indicators with cardio-metabolic risk factors.

Results

The mean age of subjects were 53.7(13.1) years, 41.6 % were males. The areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to predict high cardio-metabolic risk (AUC > 0.70). Meanwhile, multinomial logistic regression showed BRI was significantly associated with high cardio-metabolic risk (OR 3.27, 95% CI 3.01–3.55). The optimal cut-off values of BRI for high cardio-metabolic risk were (< 60 y: 3.49 vs. ≥60 y: 3.46) in males and (< 60 y: 3.47 vs. ≥60 y: 3.60) in females.

Conclusions

WC, BMI WHR, and WHtR were potential obesity indicators in discriminating high cardio-metabolic risk, while BAI or ABSI was not. Moreover, BRI revealed superior predictive capacity and significant association with accumulated cardio-metabolic risk factors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-021-01905-x.

Diagnostic performance of waist-to-height ratio in identifying cardiovascular risk factors and metabolic syndrome among adult Saudis. A cross-sectional study

Objectives:

To evaluate the diagnostic performance of waist to height ratio (WHtR) to screen for cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) among Saudis.

Methods:

Between June 2013 and August 2014, a cross-sectional study of 3,063 adult Saudis of both genders from King Khalid Hospital, Riyadh, Saudi Arabia was conducted. Using the “WHO STEPwise Surveillance-Instrument V2.1”, which uses sequential steps including questionnaires and anthropometric and biochemical measurements of MetS and CVRF. Waist to height ratio validity in defining central obesity, MetS, and CVRF were tested using receiver operating characteristic curve (ROC), sensitivity, specificity, positive and negative predictive values, and accuracy. Using multivariate regression analyses for adjustment of confounders as age and gender were applied to compute adjusted odds ratios (aOR).

Results:

The diagnostic potential of WHtR was excellent for central obesity (area under the curve [AUC] = 0.98), and MetS (AUCs = 0.86); it was good for CVRF ≥2 (AUCs = 0.79) and was satisfactory for dyslipidemia (AUCs = 0.66). The sensitivities and negative predictive values exceeded 85% for diagnosing central obesity, diabetes, and hypertension. Adjusted odds ratios for age and gender showed that WHtR ≥0.50 significantly increased the risk of diabetes, hypertension, and ≥2 CVRF by almost 4-fold, and increased the risk of dyslipidemia by 2-fold.

Conclusion:

Waist height ratio showed a good diagnostic performance for CVRF and MetS among Saudis. Furthermore, WHtR ≥0.5 increased the risk of dyslipidemia, diabetes mellitus and hypertension.

Use of Anthropometric Measures of Obesity to Predict Diabetic Retinopathy in Patients with Type 2 Diabetes in China

PURPOSE

Obesity is an established risk factor for type 2 diabetes (T2D). Diabetic retinopathy (DR) is a major microvascular complication of T2D. In this cross-sectional study, we investigated the association between various anthropometric indices of obesity and DR.

PATIENTS AND METHODS

A representative sample of 1952 patients with T2D participated in this cross-sectional study conducted in Shanghai, China. Anthropometric measures of obesity including weight, height, waist circumference, hip circumference, body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were evaluated. The association between WHtR, WHR, and BMI and the presence of DR was examined with logistic regression models.

RESULTS

The prevalence of DR was higher in T2D patients with high WHtR compared to those with normal WHtR (p<0.05). A higher BMI was associated with elevated risk of DR (model 1, p=0.034; model 2, p=0.036). WHR was unrelated to the occurrence of DR (p>0.05).

CONCLUSION

WHtR and BMI but not WHR are risk factors for DR in obese patients with T2D. Patients with high WHtR and BMI should be closely monitored to prevent the development of DR.

Cardiovascular Anthropometry: What Is Best Suited for Large-Scale Population Screening in Sub-Saharan Africa?

Background : Body mass index (BMI) measures overweight/obesity. It, however, especially in sub-Saharan Africa (SSA), misclassifies cardiometabolic risk. Central obesity measures are superior. We therefore sought to compare BMI, waist-to-hip ratio (WHR) and abdominal height (AH) in predicting cardiovascular disease risk in sub-Saharan Africa. Methods : Subjects had blood pressures, BMI, and WHR determined. Blood pressure was taken, weight and height measured to generate BMI, and AH measured with a new locally fabricated abdominometer. The ability of the anthropometric indices in identifying abnormal individuals needing intervention was assessed with sensitivity, specificity, and area under the receiver operator characteristic curve. Results : Adults totaling 1,508 (728 M/780 F) adults were studied. For BMI, 985 (65.3%) were normal, while 375 (24.9%), consisting of 233 males and 142 females, had normal WHR. Blood pressure was normal in 525 (34.8%) and 317 (21.0%) for systolic and diastolic blood pressures, respectively. Using BMI as gold standard, sensitivity, specificity, positive, and negative predictive values for WHR in males were 80.7, 37.5, 62.5, and 19.3%, respectively. For females and in the same order, they were 62.0, 34.3, 65.7, and 38.0%. For AH, it was equal in both genders at 82.6, 39.2, 60.8, and 17.4%. By receiver operating curves comparing AH, WHR, and BMI against blood pressure detection, the area under the curve was 0.745, 0.604, and 0.554 for AH, BMI, and WHR, respectively. Conclusion : Abdominometer-derived AH has a better sensitivity and greater area under the receiver operator curve compared with BMI and WHR in this sub-Sahara African population; implying superiority as a cardiovascular anthropometric index.

Metabolic syndrome amongst adults in Jordan: prevalence, trend, and its association with socio-demographic characteristics

BACKGROUND

Multiple epidemiological studies were conducted amongst a variety of ethnic groups and showed discrepancies in the prevalence of metabolic syndrome (MeS) and its individual components. This study aimed to determine the prevalence of MeS in Jordan using both the Adult Treatment Panel Guidelines (ATP III) and the International Diabetes Federation (IDF) criteria. The study also aimed to assess the changes in the prevalence of MeS over time and determine its association with sociodemographic variables.

METHODS

Data from the 2017 Cardiovascular Disease Risk Factors Survey were used for this study. Socio-demographic and clinical data were collected using a structured questionnaire. Blood samples were taken for biochemical measurements. Furthermore, anthropometric characteristics were measured by the same team of trained field researchers. A sample of 4,056 individuals aged between 18 and 90 years was included in this study. The findings from the 2017 survey were compared with the findings of a 2009 survey that adopted the same methods and procedures.

RESULTS

According to the IDF criteria, the crude prevalence of Metabolic syndrome was 48.2% (52.9% among men and 46.2% among women; p < 0.001). Using the ATP III criteria, the prevalence was 44.1% (51.4% among men and 41% among women, p < 0.001). The age-standardized prevalence rate of metabolic syndrome was 44% (95% CI 42.7, 45.4) and 39.9% (95% CI 39.6, 41.2), according to both the IDF definition and ATP III criteria, respectively. The Kappa measure of agreement showed excellent agreement between the two definitions (k = 81.9%, p < 0.001). Of all participants, 41.7% met both the IDF and ATP III diagnostic criteria, 6.6% met the IDF criteria only, and 2.5% met the ATP III criteria only. The age-standardized prevalence rate of metabolic syndrome was significantly higher in 2017 (45.7% in men and 44.5% in women) than that in 2009 survey (34.6% in men and 39.8% in women). Gender, age, occupation, region, and marital status were significantly associated with metabolic syndrome.

CONCLUSIONS

The prevalence of metabolic syndrome in Jordan is considerably high and it is increasing. Healthy lifestyle programs encouraging appropriate dietary habits and physical activity are strongly recommended in Jordan.

An alarmingly high and increasing prevalence of obesity in Jordan

OBJECTIVES

The aim of this study was to determine the prevalence of obesity in Jordan, to assess related trends, and to determine associated factors and comorbidities.

METHODS

A multipurpose national household survey of Jordanian adults was conducted over a 4-month period in 2017. Data were collected using a structured validated questionnaire. Anthropometric measurements including waist circumference (WC; measured midway between the iliac crest and the lower rib margin), body mass index (BMI), hip circumference, waist-to-hip ratio, and waist-to-height ratio were obtained to categorize participants with regard to overweight and obesity.

RESULTS

This study included 4,056 persons (1,193 men and 2,863 women) aged 18 years to 90 years (mean±standard deviation, 43.8±14.2 years). According to the International Diabetes Federation WC criteria, the age-standardized prevalence of obesity was 60.4% among men and 75.6% among women, while approximately three-quarters of men and women were overweight or obese as defined by BMI. The age-adjusted odds of obesity in 2017 were approximately twice those in 2009 in men (odds ratio [OR], 1.98) and women (OR, 1.96). In the multivariate analysis, age, region of residence, and marital status were significantly associated with obesity in both genders. Obesity was significantly associated with increased odds of diabetes mellitus, hypertension, elevated triglycerides, and low high-density lipoprotein cholesterol after adjusting for age.

CONCLUSIONS

The rate of obesity in Jordan is high and increasing, and obesity is associated with other metabolic abnormalities. Well-defined programs to control and prevent obesity, as well as intersectoral action, are urgently required to reverse current trends.

Comparison of anthropometric indices as predictors of the risk factors for cardiovascular disease in Iran: The PERSIAN Guilan Cohort Study

OBJECTIVE

This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults.

METHODS

A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), conicity index, hip circumference (HC), waist to hip to height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out of range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model.

RESULTS

The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high density lipoprotein cholesterol (HDL C) and high low density lipoprotein cholesterol (LDL C) was found in an increase in the WHR and ABSI, respectively.

CONCLUSION

Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL C/HDL C ratio.