title: Utility of anthropometric measures in a multiethnic population: their association with prevalent diabetes, hypertension and other chronic disease comorbidities.
abstract: Body mass index (BMI) and waist circumference (WC) are two common anthropometric measures of obesity in clinical and public health practice. Consensus, however, remains elusive regarding their utility for predicting cardiovascular disease risk in multiethnic populations. We address this gap in the literature by analyzing cross-sectional data from the first round of the Los Angeles County Health and Nutrition Examination Survey, 2011. We characterized the relationships between BMI, WC, waist-to-hip ratios, waist-to-height ratios, and chronic disease extent, as confirmed by the presence of hypertension, diabetes, and/or two or more other chronic conditions as defined by a composite indicator 'comorbidity'. To account for race/ethnicity, age, gender, and cigarette smoking frequency, adjusted odds ratios (aOR) were generated and reported for each of the regression analyses. Whereas being overweight was associated with hypertension alone (aOR 2.10; 95% CI 1.12-3.94), obesity was associated with hypertension (aOR 5.04; 95% CI 2.80-9.06) as well as diabetes (aOR 5.28; 95% CI 2.25-12.3) and comorbidity (aOR 3.69; 95% CI 2.02-6.77). In whites and African-Americans, BMI and WC were positively related to diabetes, hypertension and comorbidity. In Hispanics, BMI and WC were also positively related to diabetes and comorbidity, but only the former measure was associated with hypertension (p < 0.050). In Asians, BMI was not a significant predictor of diabetes, hypertension and/or comorbidity. Collectively, the findings suggest that BMI is not universally informative and waist circumference and its derivatives may represent a viable, more racially/ethnically appropriate alternative for use with selected minority groups.
authors.affiliation: Department of Health and Human Sciences, Loyola Marymount University, 211 North Hall, One LMU Drive, MS 8160, Los Angeles, CA, 90045-2659, USA, Heather.Tarleton@lmu.edu.
authors.forename: Heather P
authors.initials: HP
authors.lastname: Tarleton
authors.forename: Lisa V
authors.initials: LV
authors.lastname: Smith
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Zhang
authors.forename: Tony
authors.initials: T
authors.lastname: Kuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D055815:Young Adult