Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan

• Published in: International Journal of Obesity Vol. 26; no. 9; pp. 1232 - 1238
• Main Authors: LIN, W.-Y, LEE, L.-T, CHEN, C.-Y, LO, H, HSIA, H.-H, LIU, I.-L, LIN, R.-S, SHAU, W.-Y, HUANG, K.-C
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing 01.09.2002; Nature Publishing Group
• Subjects: Adult; Analysis. Health state; Anthropometry; Area Under Curve; Biological and medical sciences; Blood pressure; Body Constitution - physiology; Body fat; Body Height - physiology; Body Mass Index; Body weight; Body Weight - physiology; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cholesterol; Coronary heart disease; Diabetes; Diabetes Complications; Epidemiology; Female; General aspects; Glucose; Health risks; Heart; High density lipoprotein; Hospitals; Humans; Hyperlipidemias - complications; Hypertension; Hypertension - complications; Lipoproteins; Male; Medical sciences; Medical screening; Medicine; Metabolic diseases; Metabolic disorders; Obesity; Obesity - complications; Obesity - epidemiology; Odds Ratio; Overweight; Predictive Value of Tests; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; ROC Curve; Systemic diseases; Taiwan; Triglycerides; Womens health; Asia; Taiwan; Human; Obesity; Anthropometry; Nutrition disorder; Risk factor; Cardiovascular disease; Coronary heart disease; Nutritional status
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802040

The increased health risks associated with obesity have been found to occur in Asians at lower body mass indices (BMIs). To determine the optimal cut-off values for overweight or obesity in Taiwan, we examined the relationships between four anthropometric indices and cardiovascular risk factors. The data were collected from four health-screening centers from 1998 to 2000 in Taiwan. Included were 55 563 subjects (26 359 men and 29 204 women, mean age=37.3+/-10.9 and 37.0+/-11.1 y, respectively). None had known major systemic diseases or were taking medication. Individual body weight, height, waist circumference (WC), and a series of tests related to cardiovascular risk (blood pressure, fasting plasma glucose, triglycerides, total cholesterol, low- and high-density lipoprotein cholesterol) were assessed and their relationships were examined. Receiver operating characteristic (ROC) analysis was used to find out the optimal cut-off values of various anthropometric indices to predict hypertension, diabetes mellitus and dyslipidemia. Of the four anthropometric indices we studied, waist-to-height ratio (WHtR) in women was found to have the largest areas under the ROC curve (women=0.755, 95% CI 0.748-0.763) relative to at least one risk factor (ie hypertension or diabetes or dyslipidemia). The optimal cut-off values for overweight or obesity from our study in men and women showed that BMIs of 23.6 and 22.1 kg/m(2), WCs of 80.5 and 71.5 cm, waist-to-hip ratios (WHpR) of 0.85 and 0.76, and WHtR of 0.48 and 0.45, respectively, may be more appropriate in Taiwan. WHtR may be a better indicator for screening overweight- or obesity-related CVD risk factors than the other three indexes (BMI, WC and WHpR) in Taiwan. Our study also supported the hypothesis that the cut-off values using BMI and WC to define obesity should be much lower in Taiwan than in Western countries.