title: Detection of cardio-metabolic risk by BMI and waist circumference among a population of Guatemalan adults.
abstract: BACKGROUND
  BMI and waist circumference (WC) are used to screen for cardio-metabolic risk; however it is unclear how well these indices perform in populations subject to childhood stunting.
  
  
  OBJECTIVE
  To evaluate BMI and WC as indicators of cardio-metabolic risk and to determine optimal cut-off points among 1,325 Guatemalan adults (44 % stunted: 162 cm men).
  
  
  METHODS
  Cardio-metabolic risk factors were systolic/diastolic blood pressure 85 mmHg, glucose 5 mmol/l, TAG 7 mmol/l, ratio of total cholesterol to HDL-cholesterol 0, and the presence of two or more and three or more of the preceding risk factors. Receiver operating characteristic (ROC) curve analysis was used.
  
  
  RESULTS
  Areas under the ROC curve were in the range of 005978 for WC among men and 006472 among women, respectively. Optimal cut-off points for BMI were 242651 kg/m2 stunted; 242656 kg/m2 among women (262769 kg/m2 non-stunted). Optimal cut-off points for WC were 879134 cm stunted; 889333 cm among women (909486 cm non-stunted).
  
  
  CONCLUSIONS
  Optimal cut-off points for BMI were slightly higher among women than men with no meaningful differences by stature. Optimal cut-off points for WC were several centimetres lower for stunted compared with non-stunted men, and both were substantially lower than the current recommendations among Western populations. Cut-off points derived from Western populations may not be appropriate for developing countries with a high prevalence of stunting.
authors: Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA.
authors: Cria O
authors: CO
authors: Gregory
authors: Camila
authors: C
authors: Corvalán
authors: Manuel
authors: M
authors: Ramirez-Zea
authors: Reynaldo
authors: R
authors: Martorell
authors: Aryeh D
authors: AD
authors: Stein
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D050356:Lipid Metabolism / Q000502:physiology; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D012372:ROC Curve; D012015:Reference Standards; D012016:Reference Values; D012307:Risk Factors; D012737:Sex Factors; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose