Research Article
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Year 2022, , 1133 - 1138, 20.07.2022
https://doi.org/10.32322/jhsm.1126149

Abstract

References

  • Blüher M. Obesity: global epidemiology and pathogenesis. Nature Rev Endocrinol 2019; 15: 288-98.
  • Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28: 169-80.
  • Satman I, Yilmaz T, Sengul A, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care 2002; 25: 1551-6.
  • Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083-96.
  • Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968-77.
  • Li WC, Chen IC, Chang YC, Loke SS, Wang SH, Hsiao KY. Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36,642 Taiwanese adults. Eur J Nutr 2013; 52: 57-65.
  • Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama 2003; 289: 76-9.
  • Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev 2017; 18: 715-23.
  • Ashwell M, Lejeune S, McPherson K. Ratio of waist circumference to height may be better indicator of need for weight management. Bmj 1996; 312: 377.
  • Hsieh SD, Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in men-waist/height ratio as a simple and useful predictor. Int J Obes Relat Metab Disord 1995; 19: 585-9.
  • Lee JS, Aoki K, Kawakubo K, Gunji A. A study on indices of body fat distribution for screening for obesity. Sangyo Eiseigaku Zasshi 1995; 37: 9-18.
  • Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev 2010; 23: 247-69.
  • Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 2005; 56: 303-7.
  • Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012; 13: 275-86.
  • Savva SC, Lamnisos D, Kafatos AG. Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis. Diabetes Metab Syndr Obes 2013; 6: 403-19.
  • National Clinical Guideline C. National Institute for Health and Clinical Excellence: Guidance. Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43. London: National Institute for Health and Care Excellence (UK) Copyright © National Clinical Guideline Centre, 2014.
  • Ashwell M, Gibson S. Waist-to-height ratio as an indicator of 'early health risk': simpler and more predictive than using a 'matrix' based on BMI and waist circumference. BMJ Open 2016; 6: e010159.
  • Surveillance report 2018 – Obesity: identification, assessment and management (2014) NICE guideline CG189 and BMI: preventing ill health and premature death in black, Asian and other minority ethnic groups (2013) NICE guideline PH46. London: National Institute for Health and Care Excellence (UK) Copyright © NICE 2018.
  • Meseri R, Ucku R, Unal B. Waist: height ratio: a superior index in estimating cardiovascular risks in Turkish adults. Public health Nutr 2014; 17: 2246-52.
  • Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253.
  • Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-421.
  • Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
  • Larsson B, Svärdsudd K, Welin L, Wilhelmsen L, Björntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed) 1984; 288: 1401-4.
  • Croft JB, Keenan NL, Sheridan DP, Wheeler FC, Speers MA. Waist-to-hip ratio in a biracial population: measurement, implications, and cautions for using guidelines to define high risk for cardiovascular disease. J Am Diet Assoc 1995; 95: 60-4.
  • Can AS, Yıldız EA, Samur G, et al. Optimal waist: height ratio cut-off point for cardiometabolic risk factors in Turkish adults. Public Health Nutr 2010; 13: 488-95.
  • He Y, Zhai F, Ma G, et al. Abdominal obesity and the prevalence of diabetes and intermediate hyperglycaemia in Chinese adults. Public Health Nutr 2009; 12: 1078-84.
  • He Y-H, Chen Y-C, Jiang G-X, et al. Evaluation of anthropometric indices for metabolic syndrome in Chinese adults aged 40 years and over. Eur J Nutr 2012; 51: 81-7.
  • Mellati AA, Mousavinasab SN, Sokhanvar S, Kazemi SAN, Esmaill MH, Dinmohamadi H. Correlation of anthropometric indices with common cardiovascular risk factors in an urban adult population of Iran: data from Zanjan Healthy Heart Study. Asia Pacific J Clin Nutr 2009; 18: 217-25.
  • Lee DH, Keum N, Hu FB, et al. Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women. Eur J Epidemiol 2018; 33: 1113-23.
  • Son YJ, Kim J, Park H-J, et al. Association of waist-height ratio with diabetes risk: a 4-year longitudinal retrospective study. Endocrinol Metab 2016; 3: 127-33.
  • Schneider HJ, Friedrich N, Klotsche J, et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab 2010; 95: 1777-85.
  • Hsieh SD, Muto T. Metabolic syndrome in Japanese men and women with special reference to the anthropometric criteria for the assessment of obesity: Proposal to use the waist-to-height ratio. Prev Med 2006; 42: 135-9.
  • Can AS, Bersot TP, Gönen M. Anthropometric indices and their relationship with cardiometabolic risk factors in a sample of Turkish adults. Public Health Nutr 2009; 12: 538-46.
  • Collaboration OiA. Is central obesity a better discriminator of the risk of hypertension than body mass index in ethnically diverse populations? J Hypertens 2008; 26: 169-77.
  • Colin Bell A, Adair LS, Popkin BM. Ethnic differences in the association between body mass index and hypertension. Am J Epidemiol 2002; 155: 346-53.
  • Cassano PA, Segal MR, Vokonas PS, Weiss ST. Body fat distribution, blood pressure, and hypertension: a prospective cohort study of men in the normative aging study. Ann Epidemiol 1990; 1: 33-48.
  • Macmohan S, Cutler J, Brittain E, Higgins M. Obesity and hypertension: epidemiological and clinical issues. Eur Heart J 1987; 8: 57-70.
  • Stamler R, Stamler J, Riedlinger WF, Algera G, Roberts RH. Weight and blood pressure: findings in hypertension screening of 1 million Americans. JAMA 1978; 240: 1607-10.
  • Landi F, Calvani R, Picca A, et al. Body mass index is strongly associated with hypertension: results from the longevity check-up 7+ study. Nutrients 2018; 10: 1976.

The utilization of BMI in patients with high WHtR as to cardiovascular risk

Year 2022, , 1133 - 1138, 20.07.2022
https://doi.org/10.32322/jhsm.1126149

Abstract

Introduction: A waist to height ratio (WHtR) greater than 0.5 may be a global screening tool for cardiovascular disease (CVD) and diabetes. However, it is unclear whether WHtR could be used instead of BMI. This study aimed to evaluate the role of BMI regarding CVD and diabetes in a subset of Turkish adults with WHtR greater than 0.5.
Material and Method: The cross-sectional study involved 118 participants with WHtR>0.5, 18 years and older who applied to the endocrinology and metabolism disease outpatient clinic between September 2019 and February 2020. WHtR and BMI were calculated.
Results: The prevalence of hypertension and hyperlipidemia increased with BMI. WHtR was correlated with FBG. BMI was significantly associated with TG, HDL-c, SBP, and DBP in linear regression analysis, but not with FBG. On the other hand, there was a significant association between WHtR and FBG.
Conclusion: This study confirmed that the simple value of ‘0.5’ for WHtR was associated with diabetes risk. The cut-off value of 35 for BMI was effective categorizing participants with high blood pressure and lipid levels in paticipants with high WHtR. Further population-based studies in Turkish adults are needed to evaluate whether WHtR could be used independent from BMI as an early warning of cardiovascular risks for preventive interventions.

References

  • Blüher M. Obesity: global epidemiology and pathogenesis. Nature Rev Endocrinol 2019; 15: 288-98.
  • Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28: 169-80.
  • Satman I, Yilmaz T, Sengul A, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care 2002; 25: 1551-6.
  • Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083-96.
  • Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968-77.
  • Li WC, Chen IC, Chang YC, Loke SS, Wang SH, Hsiao KY. Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36,642 Taiwanese adults. Eur J Nutr 2013; 52: 57-65.
  • Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama 2003; 289: 76-9.
  • Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev 2017; 18: 715-23.
  • Ashwell M, Lejeune S, McPherson K. Ratio of waist circumference to height may be better indicator of need for weight management. Bmj 1996; 312: 377.
  • Hsieh SD, Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in men-waist/height ratio as a simple and useful predictor. Int J Obes Relat Metab Disord 1995; 19: 585-9.
  • Lee JS, Aoki K, Kawakubo K, Gunji A. A study on indices of body fat distribution for screening for obesity. Sangyo Eiseigaku Zasshi 1995; 37: 9-18.
  • Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev 2010; 23: 247-69.
  • Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 2005; 56: 303-7.
  • Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012; 13: 275-86.
  • Savva SC, Lamnisos D, Kafatos AG. Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis. Diabetes Metab Syndr Obes 2013; 6: 403-19.
  • National Clinical Guideline C. National Institute for Health and Clinical Excellence: Guidance. Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43. London: National Institute for Health and Care Excellence (UK) Copyright © National Clinical Guideline Centre, 2014.
  • Ashwell M, Gibson S. Waist-to-height ratio as an indicator of 'early health risk': simpler and more predictive than using a 'matrix' based on BMI and waist circumference. BMJ Open 2016; 6: e010159.
  • Surveillance report 2018 – Obesity: identification, assessment and management (2014) NICE guideline CG189 and BMI: preventing ill health and premature death in black, Asian and other minority ethnic groups (2013) NICE guideline PH46. London: National Institute for Health and Care Excellence (UK) Copyright © NICE 2018.
  • Meseri R, Ucku R, Unal B. Waist: height ratio: a superior index in estimating cardiovascular risks in Turkish adults. Public health Nutr 2014; 17: 2246-52.
  • Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253.
  • Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-421.
  • Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
  • Larsson B, Svärdsudd K, Welin L, Wilhelmsen L, Björntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed) 1984; 288: 1401-4.
  • Croft JB, Keenan NL, Sheridan DP, Wheeler FC, Speers MA. Waist-to-hip ratio in a biracial population: measurement, implications, and cautions for using guidelines to define high risk for cardiovascular disease. J Am Diet Assoc 1995; 95: 60-4.
  • Can AS, Yıldız EA, Samur G, et al. Optimal waist: height ratio cut-off point for cardiometabolic risk factors in Turkish adults. Public Health Nutr 2010; 13: 488-95.
  • He Y, Zhai F, Ma G, et al. Abdominal obesity and the prevalence of diabetes and intermediate hyperglycaemia in Chinese adults. Public Health Nutr 2009; 12: 1078-84.
  • He Y-H, Chen Y-C, Jiang G-X, et al. Evaluation of anthropometric indices for metabolic syndrome in Chinese adults aged 40 years and over. Eur J Nutr 2012; 51: 81-7.
  • Mellati AA, Mousavinasab SN, Sokhanvar S, Kazemi SAN, Esmaill MH, Dinmohamadi H. Correlation of anthropometric indices with common cardiovascular risk factors in an urban adult population of Iran: data from Zanjan Healthy Heart Study. Asia Pacific J Clin Nutr 2009; 18: 217-25.
  • Lee DH, Keum N, Hu FB, et al. Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women. Eur J Epidemiol 2018; 33: 1113-23.
  • Son YJ, Kim J, Park H-J, et al. Association of waist-height ratio with diabetes risk: a 4-year longitudinal retrospective study. Endocrinol Metab 2016; 3: 127-33.
  • Schneider HJ, Friedrich N, Klotsche J, et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab 2010; 95: 1777-85.
  • Hsieh SD, Muto T. Metabolic syndrome in Japanese men and women with special reference to the anthropometric criteria for the assessment of obesity: Proposal to use the waist-to-height ratio. Prev Med 2006; 42: 135-9.
  • Can AS, Bersot TP, Gönen M. Anthropometric indices and their relationship with cardiometabolic risk factors in a sample of Turkish adults. Public Health Nutr 2009; 12: 538-46.
  • Collaboration OiA. Is central obesity a better discriminator of the risk of hypertension than body mass index in ethnically diverse populations? J Hypertens 2008; 26: 169-77.
  • Colin Bell A, Adair LS, Popkin BM. Ethnic differences in the association between body mass index and hypertension. Am J Epidemiol 2002; 155: 346-53.
  • Cassano PA, Segal MR, Vokonas PS, Weiss ST. Body fat distribution, blood pressure, and hypertension: a prospective cohort study of men in the normative aging study. Ann Epidemiol 1990; 1: 33-48.
  • Macmohan S, Cutler J, Brittain E, Higgins M. Obesity and hypertension: epidemiological and clinical issues. Eur Heart J 1987; 8: 57-70.
  • Stamler R, Stamler J, Riedlinger WF, Algera G, Roberts RH. Weight and blood pressure: findings in hypertension screening of 1 million Americans. JAMA 1978; 240: 1607-10.
  • Landi F, Calvani R, Picca A, et al. Body mass index is strongly associated with hypertension: results from the longevity check-up 7+ study. Nutrients 2018; 10: 1976.
There are 39 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Meliha Melin Uygur 0000-0002-6569-8142

Publication Date July 20, 2022
Published in Issue Year 2022

Cite

AMA Uygur MM. The utilization of BMI in patients with high WHtR as to cardiovascular risk. J Health Sci Med /JHSM /jhsm. July 2022;5(4):1133-1138. doi:10.32322/jhsm.1126149

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