Optimal anthropometric factor cutoffs for hyperglycemia, hypertension and dyslipidemia for the Taiwanese population.
BACKGROUND
Optimal cutoffs for obesity indices are rarely studied in Asians. We evaluated these cutoffs for diabetes, hypertension, dyslipidemia and any risk factor for the Taiwanese general population.


METHODS
Body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHeiR) and other data for 4683 (2280 men and 2403 women) participants of the population-based Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia were used. Areas under curves (AUCs) were analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity. Potential confounders included age, smoking, alcohol, betel nut chewing and exercise.


RESULTS
Optimal cutoffs for men and women, respectively, were 23.7-26.3 and 22.1-23.2 kg/m2 for BMI; 85.0-87.0 and 74.0-83.0 cm for WC; 0.87-0.90 and 0.78-0.83 for WHR; and 0.48-0.52 and 0.48-0.52 for WHeiR. AUCs were not significantly different among the indices for diabetes in men and for hypertension in women. In men, WHR was significantly inferior to the other indices for predicting hypertension, dyslipidemia and any risk factor. In women, BMI was significantly inferior to the others for diabetes. For dyslipidemia and any risk factor in women, WHeiR showed the largest AUCs and significant differences were seen in the following pairs: WHeiR vs. BMI and WHeiR vs. WHR for dyslipidemia and WC vs. WHR and WHeiR vs. WHR for any risk factor.


CONCLUSIONS
WC and WHeiR have similar efficacy and are superior to BMI and WHR. However, WHeiR has the extra benefit of a unisex cutoff within a narrow range.
Tseng
Chin-Hsiao
CH
National Taiwan University College of Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. ccktsh@ms6.hinet.net
Chong
Choon-Khim
CK
Chan
Ting-Ting
TT
Bai
Chyi-Huey
CH
You
San-Lin
SL
Chiou
Hung-Yi
HY
Su
Ta-Chen
TC
Chen
Chien-Jen
CJ
D000886:Anthropometry; D019540:Area Under Curve; D001823:Body Composition; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000175:diagnosis; D050171:Dyslipidemias / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000453:epidemiology; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D012016:Reference Values; D012307:Risk Factors; D013624:Taiwan; D049629:Waist-Hip Ratio