title: Are waist circumference and body mass index independently associated with cardiovascular disease risk in Chinese adults?
abstract: BACKGROUND
  In Western populations, waist circumference (WC) is more predictive of cardiovascular disease (CVD) risk than is body mass index (BMI). It is unclear whether the same is true in Asian populations.
  
  
  OBJECTIVE
  The objective was to examine the independent effects of WC and BMI on CVD risk factors in China.
  
  
  METHODS
  CVD risk factors, BMI, and WC were measured in a nationally representative cross-sectional study of 15 540 Chinese adults aged 35-74 y.
  
  
  RESULTS
  Higher WC tertiles were associated with higher blood pressure and higher cholesterol, triacylglycerol, and glucose concentrations within each tertile of BMI and vice versa. In men, the odds of hypertension, dyslipidemia, and the metabolic syndrome (MS) increased with successive WC tertiles (1.0, 1.1, and 1.8, respectively, for hypertension; 1.0, 1.4, and 2.0, respectively, for dyslipidemia; and 1.0, 2.3, and 4.8, respectively, for MS; P for trend < 0.001 for all), even after adjustment for BMI. Similarly, the odds of hypertension, dyslipidemia, and MS increased with successive BMI tertiles (1.0, 1.5, and 2.6, respectively, for hypertension; 1.0, 1.3, and 1.8, respectively, for dyslipidemia; 1.0, 1.3, and 2.9, respectively for MS; P for trend < 0.001 for all), even after adjustment for WC. However, BMI tertiles were not associated with the odds of diabetes after adjustment for WC (P for trend = 0.67), whereas tertiles of WC were significantly associated with the odds of diabetes after adjustment for BMI (1.0, 1.6, and 2.1, respectively; P for trend = 0.002). The results were similar in women.
  
  
  CONCLUSIONS
  These data show that WC adds additional risk information to that of BMI in Chinese adults. Measurement of both WC and BMI in Chinese adults may enhance CVD risk stratification.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA. rwildman@tulane.edu
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Wildman
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Gu
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Xiufang
authors.initials: X
authors.lastname: Duan
authors.forename: Xiqui
authors.initials: X
authors.lastname: Wu
authors.forename: Jiang
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology / Q000209:etiology; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D049629:Waist-Hip Ratio