4.4 Article

Derivation of anthropometric cut-off levels to define CVD risk in Sri Lankan adults

Journal

BRITISH JOURNAL OF NUTRITION
Volume 105, Issue 7, Pages 1084-1090

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0007114510004563

Keywords

BMI; Waist circumference; Metabolic risk factors; CVD risk; Obesity; Sri Lanka

Funding

  1. National Science Foundation of Sri Lanka
  2. National Institute for Health Research [NF-SI-0508-10272] Funding Source: researchfish

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Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative sample of 4474 non-institutionalised adults aged >= 18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood samples were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors (P<0.001). Cut-off values for BMI, WC and WHR for males were 20.7 kg/m(2), 76.5 cm and 0.89, respectively. The respective values for females were 22.0 kg/m(2), 76.3 cm and 0.85. The common cut-off value for BMI for males and females was 21.5 kg/m(2). Similarly, WC and WHR cut-off values for both males and females were 76.3 cm and 0.87, respectively. The Asian and Caucasian anthropometric cut-off levels showed lower sensitivity and higher false negative percentage compared with newly derived cut-off levels. In conclusion, BMI, WC and WHR were all associated with increased CVD risk. We propose the following anthropometric cut-off points to determine high CVD risk level for Sri Lankan adults: BMI >= 21.5 kg/m(2), WC >= 76 cm and WHR >= 0.85 (women) and 0.90 (men).

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