Abstract
(1) Background: The study aims to estimate the prevalence of normal weight with central obesity (NWCO) and to examine the relationship between NWCO and cardiovascular disease risk factors in adults of the province of Shaanxi. (2) Methods: A population-based cross-sectional survey was conducted among residents who were aged 18–80 years and had been living in Zhenba County, Shaanxi Province, for over six months in 2018. Descriptive data analysis and prevalence/frequency were conducted. Logistic regression analyses were used to detect the corresponding factors associated with central obesity. (3) Results: A total of 2312 participants (936 men and 1376 women) were analyzed. The prevalence of NWCO was 58.3%. NWCO was significantly associated with hypertension and dyslipidemia. Compared with normal weight non-central obesity (NWNO), the adjusted odds ratios (ORs) for hypertension were 1.47 (95% CI 1.10–1.98) in men and 1.55 (1.14–2.10) in women, and the corresponding odds ratios for dyslipidemia were 2.71 (1.77–4.13) in men and 1.84 (1.29–2.61) in women. Female sex, age over 58 years, and lower education level were also significantly predictors of abdominal obesity. (4) Conclusions: Body mass index alone as a measure of obesity is not sufficient for assessing health risks. Central obesity index should be used together for clinical assessment.
Highlights
This study aims to estimate the prevalence of normal weight central obesity classified by using body mass index (BMI) and waist-to-height ratio (WHtR) and to examine the relationship between normal weight with central obesity and cardiovascular disease (CVD) risk factors in adults in Shaanxi, China
Of the 2312 participants classified as normal weight using BMI, the prevalence of central obesity was 58.3% by WHtR
The higher prevalence of normal-weight central obesity found in this study suggests the need to include anthropometric indices in the measurement of excessive body weight other than BMI alone, as BMI alone might result in misclassifications and underestimation of at-risk individuals
Summary
Excess body weight is the sixth most important risk factor contributing to the overall burden of disease worldwide [2]. A recent study showed that abdominal obesity is associated with insulin resistance and higher risks of metabolic syndrome and cardiovascular diseases in Asian females, whereas general obesity is not [6]. Central obesity has been recognised as an independent risk factor for cardio-metabolic diseases and a better predictor of cardiovascular risk than overall obesity [7,8]. Defined by normal body mass index (BMI) and higher waist-to-height ratio, normal weight with central obesity (NWCO) has been recognised as a risk factor for cardio-metabolic diseases [9]. The most common form of obesity is usually assessed by BMI [10], which has the main limitation of not differentiating body fat from lean mass and central from peripheral fat. Athletes with enhanced body muscle mass may be misclassified as obese when using only
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