Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African-Americans.
OBJECTIVE
Prior studies have supported that waist circumference correlates better with visceral adipose tissue and is a better predictor of cardiovascular disease than are BMI and waist-to-hip ratio. In this study, we reexamine the role of waist size on the risk of hypertension and type 2 diabetes in African-origin populations from three contrasting environments.


METHODS
A cross-sectional survey was conducted of 5,042 men and women 25-74 years of age from Nigeria, Jamaica, and the U.S. The relationship between waist, blood pressure, and fasting blood glucose was assessed using multiple linear regression analyses. Logistic regression analyses using sex-specific empirical waist cut-points were used to determine the risks of hypertension and type 2 diabetes.


RESULTS
Waist circumference was positively correlated with blood pressure and fasting blood glucose (P < 0.05). Increasing waist quartiles were significantly associated with higher risks of hypertension in the three populations, as estimated from age-adjusted odds ratios obtained from sex-specific logistic regression models. A highly elevated risk of type 2 diabetes-10-fold for Jamaican men and 23-fold for African-American women-was observed in the comparison of lowest to highest quartiles of waist circumference.


CONCLUSIONS
Substantial reduction in hypertension and diabetes in men and women is achievable if the waist size is decreased in these populations. Intervention programs designed to reduce waist circumference through lifestyle modification, including exercise and diet, may have significant public health significance in reducing the incidence of hypertension and adult-onset diabetes in these populations.
Okosun
I S
IS
Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, Illinois 60153, USA. iokosun@wpo.it.luc.edu
Cooper
R S
RS
Rotimi
C N
CN
Osotimehin
B
B
Forrester
T
T
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D044383:Black People; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000208:ethnology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology*; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
D001786:Blood Glucose