title: Derivation of anthropometric cut-off levels to define CVD risk in Sri Lankan adults.
abstract: Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative sample of 4474 non-institutionalised adults aged ≥ 18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood samples were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors (P < 0·001). Cut-off values for BMI, WC and WHR for males were 20·7 kg/m2, 76·5 cm and 0·89, respectively. The respective values for females were 22·0 kg/m2, 76·3 cm and 0·85. The common cut-off value for BMI for males and females was 21·5 kg/m2. Similarly, WC and WHR cut-off values for both males and females were 76·3 cm and 0·87, respectively. The Asian and Caucasian anthropometric cut-off levels showed lower sensitivity and higher false negative percentage compared with newly derived cut-off levels. In conclusion, BMI, WC and WHR were all associated with increased CVD risk. We propose the following anthropometric cut-off points to determine high CVD risk level for Sri Lankan adults: BMI ≥ 21·5 kg/m2, WC ≥ 76 cm and WHR ≥ 0·85 (women) and 0·90 (men).
authors.affiliation: Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 8, Sri Lanka. pkatulanda@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Katulanda
authors.forename: M A R
authors.initials: MA
authors.lastname: Jayawardena
authors.forename: M H R
authors.initials: MH
authors.lastname: Sheriff
authors.forename: D R
authors.initials: DR
authors.lastname: Matthews
mesh_terms: D000328:Adult; D000886:Anthropometry; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology*; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D012737:Sex Factors; D013188:Sri Lanka; D055105:Waist Circumference / Q000208:ethnology*; D049629:Waist-Hip Ratio; D044465:White People