Efficiency of anthropometric indicators of obesity for identifying cardiovascular risk factors in a Chinese population

Objective To evaluate the predictive value of the body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) for the presence of several cardiovascular risk conditions-hypertension, dyslipidaemia, metabolic syndrome (MS), and type 2 diabetesd-in a Chinese population in Jinan, China. Methods Data for a representative, cross-sectional sample of 3006 adults (mean age; range 20-74 years) in Jinan from 2007 to 2008 were studied. The association of BMI, WC, and WHtR with cardiovascular risk conditions was assessed by use of receiver operating characteristic curve (ROC) analysis and by calculating the area under the ROC (AUC) and age adjusted odds ratios (ORs) for metabolic syndrome, dyslipidaemia, type 2 diabetes, and hypertension. Results AUC cut-off values showed that the association of WHtR and WC was higher than that for BMI for all risk conditions for both sexes, except for hypertension in men. The AUC values for WC showed a higher association with hypertension and metabolic syndrome for women than men (p<0.01 for hypertension, p<0.05 for metabolic syndrome). The ORs were highest for WHtR for metabolic syndrome, diabetes, and hypertension in women. The ORs were highest for BMI for hypertension in men. Conclusions Compared with BMI, measures of central obesity, particularly WHtR, show a better association with obesity related cardiovascular risk conditions for both sexes, except for hypertension in men, in Jinan, China.