Abstract
To explore a scientific boundary of WHtR to evaluate central obesity and CVD risk factors in a Chinese adult population. The data are from the Prospective Urban Rural Epidemiology (PURE) China study that was conducted from 2005–2007. The final study sample consisted of 43 841 participants (18 019 men and 25 822 women) aged 35–70 years. According to the group of CVD risk factors proposed by Joint National Committee 7 version and the clustering of risk factors, some diagnosis parameters, such as sensitivity, specificity and receiver operating characteristic (ROC) curve least distance were calculated for hypertension, diabetes, high serum triglyceride (TG), high serum low density lipoprotein cholesterol (LDL-C), low serum high density lipoprotein cholesterol (HDL-C) and clustering of risk factors (number≥2) to evaluate the efficacy at each value of the WHtR cut-off point. The upper boundary value for severity was fixed on the point where the specificity was above 90%. The lower boundary value, which indicated above underweight, was determined by the percentile distribution of WHtR, specifically the 5th percentile (P5) for both males and females population. Then, based on convenience and practical use, the optimal boundary values of WHtR for underweight and obvious central obesity were determined. For the whole study population, the optimal WHtR cut-off point for the CVD risk factor cluster was 0.50. The cut-off points for severe central obesity were 0.57 in the whole population. The upper boundary values of WHtR to detect the risk factor cluster with specificity above 90% were 0.55 and 0.58 for men and women, respectively. Additionally, the cut-off points of WHtR for each of four cardiovascular risk factors with specificity above 90% in males ranged from 0.55 to 0.56, whereas in females, it ranged from 0.57 to 0.58. The P5 of WHtR, which represents the lower boundary values of WHtR that indicates above underweight, was 0.40 in the whole population. WHtR 0.50 was an optimal cut-off point for evaluating CVD risks in Chinese adults of both genders. The optimal boundaries of WHtR were 0.40 and 0.57, indicating low body weight and severe risk for CVD, respectively, in Chinese adults.
Highlights
Central obesity has been a growing worldwide health problem [1]
In 1995 and 1996, waist-to-height ratio (WHtR) was, for the first time, referred to as an anthropometric measure by researchers in Japan and the UK [9, 10], who suggested that the same cut-off point value (WHtR 0.50) for central obesity and cardiovascular disease (CVD) risks be used in both men and women [11, 12]
The prevalence rates among male participants of hypertension, high TG, and risk factor clusters was significantly higher than the corresponding prevalence rates among female participants, and the rates of females with high low density lipoprotein cholesterol (LDL-C) and low high density lipoprotein cholesterol (HDL-C) were higher than those of males
Summary
Central obesity has been a growing worldwide health problem [1]. As has been reported, it is one of the well-known risk factors for cardiovascular disease (CVD) and is shown to be associated with hypertension, diabetes mellitus and dyslipidemia [2,3,4,5,6]. In 1995 and 1996, waist-to-height ratio (WHtR) was, for the first time, referred to as an anthropometric measure by researchers in Japan and the UK [9, 10], who suggested that the same cut-off point value (WHtR 0.50) for central obesity and CVD risks be used in both men and women [11, 12]. WHtR 0.50 can be the cut-off point for central obesity and CVD risks with no gender-specific, ethnicity-specific or height-corrected advantages. This point value alone cannot show the severity and risks of obesity. The purpose of this study was to explore a scientific boundary of WHtR using data from the PURE—China study, whose samples from urban and rural area in China, to evaluate central obesity and CVD risk factors in Chinese adults
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