Heterogeneity of body mass index, waist circumference, and waist-to-hip ratio in predicting obesity-related metabolic disorders for Taiwanese aged 35–64y

Received 8 September 2008; accepted 13 April 2009. published online 15 July 2009.

Summary

Background & aims

Obesity-related metabolic disorders such as hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, and hyperuricemia are major risk factors for cardiovascular disease. The aim was to compare body mass index, waist circumference, and waist-to-hip ratio as predictors of these metabolic disorders.

Methods

We evaluated 1625 men and 1779 women, aged 35–64y who participated in the 2001 National Health Interview Survey and 2002 Taiwan Three High Prevalence Survey. Their anthropometric measurements were analyzed as predictors of metabolic disorders using empirical receiver-operating characteristic curves and logistic regression models.

Results

Overall, waist circumference performed well as a predictor of metabolic disorders. Body mass index was the best predictor for men who smoked, whereas waist circumference and waist-to-hip ratio were better alternatives for non-smoking men and women. Anthropometric measures had higher predictabilities for those aged 35–44y but relatively weak associations with diabetes mellitus for men aged 45–64y and hypercholesterolemia for men and women.

Conclusions

The associations between anthropometric measures and the metabolic disorders varied with comorbidity, gender, age groups, and smoking status. Waist-to-hip ratio was the best predictor for diabetes mellitus, especially for participants aged 45–64y. The anthropometric measures did not predict hypercholesterolemia well.

Keywords: Anthropometric measurement, Cardiovascular disease, Metabolic syndrome, Receiver-operating characteristic

Non-standard abbreviations: AUC, area under curve, BMI, body mass index, HBP, high blood pressure, HC, hip circumference, H-Chol, hypercholesterolemia, H-TG, hypertriglyceridemia, H-UA, hyperuricemia, ROC, receiver-operating characteristic, WC, waist circumference, WHR, waist-to-hip ratio, WHtR, waist-to-height ratio, WSR, waist-to-stature ratio

a Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 350, Taiwan

b Center for Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan

c Department of Educational Psychology, University of Wisconsin–Madison, Madison, WI, USA

Corresponding author. Tel.: +886 37 246 166x36186; fax: +886 37 586 467.

PII: S0261-5614(09)00091-0

doi:10.1016/j.clnu.2009.04.017

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