title: Optimal cut-off values of BMI, waist circumference and waist:height ratio for defining obesity in Chinese adults.
abstract: It has not been established which specific measures of obesity might be most appropriate for predicting CVD risk in Asians. The objectives of the present study were to determine the associations of BMI, waist circumference (WC) and waist:height ratio (WHtR) with CVD risk factors and to evaluate the optimal cut-off values to define overweight or obesity in Chinese adults. Data collected from seven nationwide health examination centres during 2008 and 2009 were analysed. The BMI, WC and WHtR of 244 266 Chinese adults aged ≥ 20 years included in the study were measured. Logistic regression models were fit to evaluate the OR of each CVD risk factor according to various anthropometric indices. Receiver operating characteristic (ROC) analyses were conducted to assess the optimal cut-off values to predict the risk of diabetes, hypertension, dyslipidaemia and the metabolic syndrome. WHtR had the largest areas under the ROC curve for all CVD risk factors in both sexes, followed by WC and BMI. The optimal cut-off values were approximately 24·0 and 23·0 kg/m2 for BMI, 85·0 and 75·0 cm for WC, and 0·50 and 0·48 for WHtR for men and women, respectively. According to well-established cut-off values, BMI was found to be a more sensitive indicator of hypertension in both men and women, while WC and WHtR were found to be better indicators of diabetes and dyslipidaemia. A combination of BMI and central obesity measures was found to be associated with greater OR of CVD risk factors than either of them alone in both sexes. The present study demonstrated that WHtR and WC may be better indicators of CVD risk factors for Chinese people than BMI.
authors.affiliation: International Medical Center, Chinese People's Liberation Army General Hospital,28 Fuxing Road,Beijing100083,People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: National Research Institute for Family Planning,Beijing100081,People's Republic of China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: He
authors.affiliation: International Medical Center, Chinese People's Liberation Army General Hospital,28 Fuxing Road,Beijing100083,People's Republic of China.
authors.forename: Shengyong
authors.initials: S
authors.lastname: Dong
authors.affiliation: Southwest Hospital, Third Military Medical University,Chongqing400038,People's Republic of China.
authors.forename: Xiaolan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Third Xiangya Hospital, Central South University,Changsha410013,People's Republic of China.
authors.forename: Zhiheng
authors.initials: Z
authors.lastname: Chen
authors.affiliation: The Second Affiliated Hospital, Medical College of Zhejiang University,Hangzhou310009,People's Republic of China.
authors.forename: Zhenya
authors.initials: Z
authors.lastname: Song
authors.affiliation: Bethune International Peace Hospital,Shijiazhuang050082,People's Republic of China.
authors.forename: Guang
authors.initials: G
authors.lastname: Chang
authors.affiliation: The First Hospital of Jilin University,Changchun130021,People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.affiliation: West China Hospital of Sichuan University,Chengdu610041,People's Republic of China.
authors.forename: Youjuan
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D002681:China; D003920:Diabetes Mellitus / Q000209:etiology; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D056128:Obesity, Abdominal / Q000150:complications / Q000175:diagnosis; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D055105:Waist Circumference; D065927:Waist-Height Ratio; D055815:Young Adult