The Effects of Obesity-Related Anthropometric Factors on Cardiovascular Risks of Homeless Adults in Taiwan.

Ching-Lin Chen,Mingchih Chen,Chih-Kuang Liu

doi:10.3390/ijerph17186833

Abstract

Homelessness is a pre-existing phenomenon in society and an important public health issue that national policy strives to solve. Cardiovascular disease (CVD) is an important health problem of the homeless. This cross-sectional study explored the effects of four obesity-related anthropometric factors—body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)—on cardiovascular disease risks (expressed by three CVD markers: hypertension, hyperglycemia, and hyperlipidemia) among homeless adults in Taipei and compared the relevant results with ordinary adults in Taiwan. The research team sampled homeless adults over the age of 20 in Taipei City in 2018 and collected 297 participants. Through anthropometric measurements, blood pressure measurements, and blood tests, we calculated the obesity-related indicators of the participants and found those at risks of cardiovascular disease. The results showed that the prevalence of hypertension, hyperglycemia, and hyperlipidemia in homeless adults was significantly higher than that of ordinary adults in Taiwan. Among the four obesity-related indicators, WHtR showed the strongest association with the prevalence of hypertension and hyperlipidemia, followed by WHR, both of which showed stronger association than traditional WC and BMI indicators. It can be inferred that abdominal obesity characterized by WHtR is a key risk factor for hypertension and hyperlipidemia in homeless adults in Taiwan. We hope that the results will provide medical clinical references and effectively warn of cardiovascular disease risks for the homeless in Taiwan.

Highlights

Homeless individuals are defined as people without a fixed residence and fixed work [1]
The waist-to-height ratio (WHtR) indicator showed the strongest association with the prevalence of hypertension and hyperlipidemia, followed by waist-to-hip ratio (WHR), both of which showed stronger association than traditional Body mass index (BMI) and waist circumference (WC) indicators
We found that the WHtR obesity classification with 0.5 as cutoff was very sensitive to the segmentation of patients with hypertension and hyperlipidemia, far exceeding the association between the other three obesity factors and the two Cardiovascular disease (CVD) markers

Summary

Introduction

Homeless individuals are defined as people without a fixed residence and fixed work [1]. Homelessness is usually caused by health problems and social factors and is related to insufficient food, alcoholism, and lack of personal hygiene [3,4]. It can lead to various diseases including mental illness, respiratory disease, cardiovascular disease, and various infectious diseases, as well as the inability to pay for medical expenses [5]. These complex medical and social issues have resulted in low life expectancy and high all-cause mortality among homeless people [6,7,8]. Medical care of the homeless is always an important public health issue

Methods

Results

Discussion

Conclusion