Abstract
Summary Background The significance of anthropometric measures of obesity that determine coronary-heart-disease (CHD) risk varies among populations. This study compares waist circumference (WC) and body mass index (BMI) in identifying the “obesity-related-CHD risk” among Sri Lankan adults. Methods A population-based cross-section of 515 adults aged 20–64 years, residing in the district of Colombo in 2004 was selected by a multi-stage, stratified, probability sampling method. WC, height and weight were measured. Demographic, socio-economic and lifestyle characteristics, smoking and obesity-related-CHD risk factors (hypertension, dyslipidaemia, diabetes) were assessed by questionnaires, physical measurements and biochemical assessments. “Obesity-related CHD risk” was defined by the presence of ⩾1 obesity-related-CHD risk factors. Results Compared to BMI, WC was a stronger correlate of systolic and diastolic blood pressure, triglycerides among both sexes and of plasma glucose among males. It was also an independent predictor of obesity-related-CHD risk in both males (beta co-efficient = 0.046; standard error = 0.013) and females (0.024; 0.012) in contrast to BMI, which was significant only among males (0.138; 0.037) in the logistic regression models adjusted for confounders. At the same level of obesity-related-CHD risk corresponding with BMI of 25 kg/m2 (OR = 1.7) and 30 kg/m2 (OR = 3.5), the corresponding WC values were 90.5 cm and 105.5 cm for males and 100 cm and 129 cm for females. The derived optimal risk thresholds of WC for identifying obesity-related-CHD risk was 88.5 cm for males and 82 cm for females. Conclusions WC with its sex-specific cutoff values can serve as a better screening tool than BMI in identifying individuals at risk of obesity-related CHD in low-resource settings.
Highlights
The relationship of obesity with morbidity and mortality of coronary heart diseases (CHD) has been widely studied in the Framingham Heart Study, Nurses’ Health Study and elsewhere [1,2]
Our study demonstrates that waist circumference (WC) is a stronger correlate of obesity-related-CHD risk factors as well as a more powerful indicator of ‘obesity-relatedCHD risk’ than body mass index (BMI)
This study highlights the use of WC as a screening tool for identifying persons at risk of CHD compared to BMI
Summary
The relationship of obesity with morbidity and mortality of coronary heart diseases (CHD) has been widely studied in the Framingham Heart Study, Nurses’ Health Study and elsewhere [1,2]. Current literature shows that both WC and BMI are powerful predictors of individual obesity-relatedCHD risk factors [7,8,9] This may suggest that these measures are useful as ideal screening tools for identifying ‘‘adults who are at risk of developing CHD’’ [10]. This will be of relevance in South Asia, where the natives of South Asian region are more prone to severe degrees of CHD [11,12]. They are known to have a higher prevalence of abdominal obesity despite having low generalized obesity [13,14]
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