title: Body mass index and waist circumference cut-points in multi-ethnic populations from the UK and India: the ADDITION-Leicester, Jaipur heart watch and New Delhi cross-sectional studies.
abstract: OBJECTIVE
  To derive cut-points for body mass index (BMI) and waist circumference (WC) for minority ethnic groups that are risk equivalent based on endogenous glucose levels to cut-points for white Europeans (BMI 30 kg/m2; WC men 102 cm; WC women 88 cm).
  
  
  METHODS
  Cross-sectional data from participants aged 40-75 years: 4,672 white and 1,348 migrant South Asian participants from ADDITION-Leicester (UK) and 985 indigenous South Asians from Jaipur Heart Watch/New Delhi studies (India). Cut-points were derived using fractional polynomial models with fasting and 2-hour glucose as outcomes, and ethnicity, objectively-measured BMI/WC, their interaction and age as covariates.
  
  
  RESULTS
  Based on fasting glucose, obesity cut-points were 25 kg/m2 (95% Confidence Interval: 24, 26) for migrant South Asian, and 18 kg/m2 (16, 20) for indigenous South Asian populations. For men, WC cut-points were 90 cm (85, 95) for migrant South Asian, and 87 cm (82, 91) for indigenous South Asian populations. For women, WC cut-points were 77 cm (71, 82) for migrant South Asian, and 54 cm (20, 63) for indigenous South Asian populations. Cut-points based on 2-hour glucose were lower than these.
  
  
  CONCLUSIONS
  These findings strengthen evidence that health interventions are required at a lower BMI and WC for South Asian individuals. Based on our data and the existing literature, we suggest an obesity threshold of 25 kg/m2 for South Asian individuals, and a very high WC threshold of 90 cm for South Asian men and 77 cm for South Asian women. Further work is required to determine whether lower cut-points are required for indigenous, than migrant, South Asians.
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester, Leicestershire, United Kingdom.
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: University of Leicester, Department of Health Sciences, Leicester, Leicestershire, United Kingdom.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester, Leicestershire, United Kingdom.
authors.forename: Joseph
authors.initials: J
authors.lastname: Henson
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester, Leicestershire, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Webb
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Guru
authors.affiliation: Fortis Hospitals, Department of Diabetes and Metabolic Diseases, New Delhi, Delhi, India.
authors.forename: Anoop
authors.initials: A
authors.lastname: Misra
authors.affiliation: Fortis Escorts Hospital, Department of Internal Medicine, Jaipur, Rajasthan, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
authors.affiliation: All India Institute of Medical Sciences, Department of Medicine, New Delhi, Delhi, India.
authors.forename: Naval
authors.initials: N
authors.lastname: Vikram
authors.affiliation: University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester, Leicestershire, United Kingdom.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester, Leicestershire, United Kingdom.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D006113:United Kingdom; D055105:Waist Circumference; D044465:White People
chemical_list: D001786:Blood Glucose