Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan
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...
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Published in | International Journal of Obesity Vol. 26; no. 9; pp. 1232 - 1238 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Basingstoke
Nature Publishing
01.09.2002
Nature Publishing Group |
Subjects | |
Online Access | Get full text |
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Abstract | 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. |
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AbstractList | 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. BACKGROUND:: 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. METHODS:: 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. RESULTS:: 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/m2 , 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. CONCLUSIONS:: 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. INTERNATIONAL JOURNAL OF OBESITY: (2002) 26, 1232-1238. doi:10.1038/sj.ijo.0802040 |
Author | LEE, L.-T LO, H LIU, I.-L HSIA, H.-H LIN, W.-Y HUANG, K.-C LIN, R.-S SHAU, W.-Y CHEN, C.-Y |
Author_xml | – sequence: 1 givenname: W.-Y surname: LIN fullname: LIN, W.-Y organization: Obesity Research Group, Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, Province of China – sequence: 2 givenname: L.-T surname: LEE fullname: LEE, L.-T organization: Obesity Research Group, Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, Province of China – sequence: 3 givenname: C.-Y surname: CHEN fullname: CHEN, C.-Y organization: Obesity Research Group, Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, Province of China – sequence: 4 givenname: H surname: LO fullname: LO, H organization: Obesity Research Group, Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, Province of China – sequence: 5 givenname: H.-H surname: HSIA fullname: HSIA, H.-H organization: Obesity Research Group, Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, Province of China – sequence: 6 givenname: I.-L surname: LIU fullname: LIU, I.-L organization: MJ Health Screening Center, Taipei, Taiwan, Province of China – sequence: 7 givenname: R.-S surname: LIN fullname: LIN, R.-S organization: Graduate Institute of Preventive & Medicine, National Taiwan University, Taipei, Taiwan, Province of China – sequence: 8 givenname: W.-Y surname: SHAU fullname: SHAU, W.-Y organization: Graduate Institute of Clinical Medicine, Taipei, Taiwan, Province of China – sequence: 9 givenname: K.-C surname: HUANG fullname: HUANG, K.-C organization: Obesity Research Group, Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, Province of China |
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ContentType | Journal Article |
Copyright | 2002 INIST-CNRS Copyright Nature Publishing Group Sep 2002 |
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Keywords | Human Obesity Anthropometry Nutrition disorder Risk factor Cardiovascular disease Coronary heart disease Nutritional status |
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References | RJ Kuczmarski (BF0802040_CR1) 1994; 272 Kopelman (BF0802040_CR4) 2000; 404 JC Seidell (BF0802040_CR8) 1996; 156 AH Kissebah (BF0802040_CR11) 1982; 54 GTC Ko (BF0802040_CR22) 1997; 21 J-P Després (BF0802040_CR19) 1991; 54 X Pi-Sunyer (BF0802040_CR5) 1991; 53 B Larsson (BF0802040_CR10) 1984; 288 BF0802040_CR28 P Deurenberg (BF0802040_CR17) 1988; 22 BF0802040_CR27 GTC Ko (BF0802040_CR36) 1999; 23 MEJ Lean (BF0802040_CR38) 1995; 311 X Pi-Sunyer (BF0802040_CR40) 1991; 53 HC Lukaski (BF0802040_CR13) 1987; 46 TS Han (BF0802040_CR37) 1995; 311 JA Swets (BF0802040_CR31) 1973; 182 BF0802040_CR3 AM Hodge (BF0802040_CR35) 1996; 20 KM Flegal (BF0802040_CR2) 1998; 22 SM Kim (BF0802040_CR42) 1998; 7 J Wang (BF0802040_CR23) 1994; 60 P Rissanen (BF0802040_CR34) 1997; 21 HB Hubert (BF0802040_CR6) 1983; 67 P Björntorp (BF0802040_CR9) 1991; 14 SD Hsieh (BF0802040_CR21) 1995; 34 BF0802040_CR33 CE Metz (BF0802040_CR30) 1978; 8 SD Hsieh (BF0802040_CR20) 1995; 19 BK William (BF0802040_CR7) 1996; 63 D Gallagher (BF0802040_CR16) 1996; 143 SD Hsieh (BF0802040_CR25) 2000; 24 RF Kushner (BF0802040_CR15) 1992; 56 J Wang (BF0802040_CR26) 1992; 4 YT van der Schouw (BF0802040_CR29) 1992; 9 BA Reeder (BF0802040_CR41) 1992; 146 M Deurenberg-Yap (BF0802040_CR24) 1999; 8 RB Mazess (BF0802040_CR12) 1990; 51 Kopelman (BF0802040_CR39) 2000; 404 KE Friedl (BF0802040_CR14) 1992; 55 MC Pouliot (BF0802040_CR18) 1994; 73 JA Hanley (BF0802040_CR32) 1982; 143 |
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Relat Metab Disord doi: 10.1038/sj.ijo.0801157 contributor: fullname: SD Hsieh – volume: 182 start-page: 990 year: 1973 ident: BF0802040_CR31 publication-title: Science doi: 10.1126/science.182.4116.990 contributor: fullname: JA Swets – volume: 156 start-page: 958 year: 1996 ident: BF0802040_CR8 publication-title: Arch Intern Med doi: 10.1001/archinte.1996.00440090054006 contributor: fullname: JC Seidell – volume: 14 start-page: 1132 year: 1991 ident: BF0802040_CR9 publication-title: Diabetes Care doi: 10.2337/diacare.14.12.1132 contributor: fullname: P Björntorp – volume: 146 start-page: 2009 year: 1992 ident: BF0802040_CR41 publication-title: Can Med Assoc J contributor: fullname: BA Reeder – volume: 19 start-page: 585 year: 1995 ident: BF0802040_CR20 publication-title: Int J Obes Relat Metab Disord contributor: fullname: SD Hsieh – volume: 54 start-page: 471 year: 1991 ident: BF0802040_CR19 publication-title: Am J Clin Nutr doi: 10.1093/ajcn/54.3.471 contributor: fullname: J-P 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Snippet | 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... BACKGROUND:: The increased health risks associated with obesity have been found to occur in Asians at lower body mass indices (BMIs). To determine the optimal... |
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SubjectTerms | 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 |
Title | Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan |
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