title: Impact of waist circumference and body mass index on risk of cardiometabolic disorder and cardiovascular disease in Chinese adults: a national diabetes and metabolic disorders survey.
abstract: BACKGROUND
  We updated the prevalence of obesity and evaluated the clinical utility of separate and combined waist circumference (WC) or body mass index (BMI) category increments in identifying cardiometabolic disorder (CMD) and cardiovascular disease (CVD) risk in Chinese adults.
  
  
  RESULTS
  46,024 participants aged ≥20 years, a nationally representative sample surveyed in 2007-2008, were included in this analysis. Taking the cutoffs recommended by the Chinese Joint Committee for Developing Chinese Guidelines (JCDCG) and the Working Group on Obesity in China (WGOC) into account, the participants were divided into four WC and four BMI groups in 0.5-SD increments around the mean, and 16 cross-tabulated combination groups of WC and BMI. 27.1%, 31.4%, and 12.2% of Chinese adults are centrally obese, overweight, or obese according to JCDCG and WGOC criteria. After adjustment for confounders, after a 1-SD increment, WC is associated with a 1.7-fold or 2.2-fold greater risk of having DM or DM plus dyslipidemia than BMI, while BMI was associated with a 2.3-fold or 1.7-fold higher hypertension or hypertension plus dyslipidemia risk than WC. The combination of WC and BMI categories had stronger association with CMD risk, i.e., the adjusted ORs (95% CI) of having DM, hypertension, and dyslipidemia for the combined and separate highest WC and BMI categories were 2.19 (1.96-2.44) vs 1.88 (1.67-2.12) and 1.12 (0.99-1.26); 5.70 (5.24-6.19) vs 1.51 (1.39-1.65) and 1.69 (1.57-1.82); and 3.73 (3.42-4.07) vs 2.16 (1.98-2.35) and 1.33 (1.25-1.40), respectively. The combination of WC and BMI categories was more likely to identify individuals with lower WC and lower BMI at CVD risk, even after the effects of CMD were controlled (all P<0.05).
  
  
  CONCLUSIONS
  Central obesity, overweight, and obesity are epidemic in Chinese adults. The combination of WC and BMI measures is superior to the separate indices in identifying CMD and CVD risk.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
authors.forename: Xuhong
authors.initials: X
authors.lastname: Hou
authors.forename: Juming
authors.initials: J
authors.lastname: Lu
authors.forename: Jianping
authors.initials: J
authors.lastname: Weng
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
authors.forename: Zhongyan
authors.initials: Z
authors.lastname: Shan
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.forename: Haoming
authors.initials: H
authors.lastname: Tian
authors.forename: Qiuhe
authors.initials: Q
authors.lastname: Ji
authors.forename: Dalong
authors.initials: D
authors.lastname: Zhu
authors.forename: Jiapu
authors.initials: J
authors.lastname: Ge
authors.forename: Lixiang
authors.initials: L
authors.lastname: Lin
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Guo
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Zhiguang
authors.initials: Z
authors.lastname: Zhou
authors.forename: Guangliang
authors.initials: G
authors.lastname: Shan
authors.forename: Zhaojun
authors.initials: Z
authors.lastname: Yang
authors.forename: Wenying
authors.initials: W
authors.lastname: Yang
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003625:Data Collection; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D050171:Dyslipidemias / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D055105:Waist Circumference