title: Measures of adiposity and cardiovascular disease risk factors, New York City Health and Nutrition Examination Survey, 2004.
abstract: BACKGROUND
  Body mass index (BMI) and indicators of central adiposity have been associated with cardiovascular disease (CVD) risk factors, but ambiguity remains about which measure optimally predicts CVD risk and is best suited for different racial/ethnic groups. We sought to characterize excess adiposity among New York City adults and assess the potential associations between multiple adiposity indicators and CVD risk factors, by race/ethnicity.
  
  
  METHODS
  The New York City Health and Nutrition Examination Survey (NYC HANES) is a population-based survey of noninstitutionalized New York City adult residents aged 20 years or older. We compared the prevalence of obesity (BMI ≥ 30 kg/m(2)), elevated waist circumference (>102 cm for men, >88 cm for women), and elevated waist-to-height ratio (≥ 0.5) for participants in the 2004 NYC HANES (n = 1,912) and the 2003-2004 National Health and Nutrition Examination Survey (n = 4,075). Logistic regression was used to assess potential associations between each of these indicators of excess adiposity and CVD risk factors (diabetes, impaired fasting glucose, hypertension, and hypercholesterolemia), overall and by race/ethnicity.
  
  
  RESULTS
  The prevalence of obesity among NYC HANES participants was 26% and of elevated waist circumference was 46%, both significantly lower than national estimates (31% and 52%, respectively), whereas the prevalence of elevated waist-to-height ratio was higher (82% vs 79%). Most measures of excess adiposity were significantly associated with all CVD risk factors. No single measure of excess adiposity emerged as most consistently predictive of CVD risk in the general population or by race/ethnicity.
  
  
  CONCLUSIONS
  New York City has a lower prevalence of obesity and elevated waist circumference but a higher prevalence of elevated waist-to-height ratio than found nationally. Further investigation into the optimal adiposity measure to predict CVD risk across racial/ethnic populations may be warranted.
authors.affiliation: Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA. crg2128@columbia.edu
authors.forename: R Charon
authors.initials: RC
authors.lastname: Gwynn
authors.forename: Magdalena
authors.initials: M
authors.lastname: Berger
authors.forename: Renu K
authors.initials: RK
authors.lastname: Garg
authors.forename: Elizabeth Needham
authors.initials: EN
authors.lastname: Waddell
authors.forename: Robyn
authors.initials: R
authors.lastname: Philburn
authors.forename: Lorna E
authors.initials: LE
authors.lastname: Thorpe
mesh_terms: D050154:Adiposity; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014481:United States; D055105:Waist Circumference; D055815:Young Adult