title: A novel quantitative body shape score for detecting association between obesity and hypertension in China.
abstract: BACKGROUND
  Obesity is a major independent risk factor for chronic diseases such as hypertension and coronary diseases, it might not be only related to the amount of body fat but its distribution. The single body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) or waist to stature ratio (WSR) provides limited information on fat distribution, and the debate about which one is the best remained. On the other hand, the current classification of body shape is qualitative rather than quantitative, and only crudely measure fat distribution. Therefore, a synthetical index is highly desirable to quantify body shape.
  
  
  METHODS
  Based on the China Health and Nutrition Survey (CHNS) data, using Lohmäller PLSPM algorithm, six Partial Least Squares Path Models (PLSPMs) between the different obesity measurements and hypertension as well as two synthetical body shape scores (BSS1 by BMI/WC/Hip circumference, BSS2 by BMI/WC/WHR/WSR) were created. Simulation and real data analysis were conducted to assess their performance.
  
  
  RESULTS
  Statistical simulation showed the proposed model was stable and powerful. Totally 15,172 (6,939 male and 8,233 female) participants aged from 18 to 87 years old were included. It indicated that age, height, weight, WC, WHR, WSR, SBP, DBP, the prevalence of hypertension and obesity were significantly sex-different. BMI, WC, WHR, WSR, Hip, BSS1 and BSS2 between hypertension and normotensive group are significantly different (p < 0.05). PLSPM method illustrated the biggest path coefficients (95% confidence interval, CI) were 0.220(0.196, 0.244) for male and 0.205(0.182, 0.228) for female in model of BSS1. The area under receiver-operating characteristic curve (AUC(95% CI)) of BSS1(0.839(0.831,0.847)) was significantly larger than that of BSS2(0.834(0.825,0.842)) as well as the four single indices for female, and similar trend can be found for male.
  
  
  CONCLUSIONS
  BSS1 was an excellent measurement for quantifying body shape and detecting the association between body shape and hypertension.
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, PO Box 100, Jinan, 250012, China. wsk2001@sdu.edu.cn.
authors.forename: Shukang
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, PO Box 100, Jinan, 250012, China. liu-yx@sdu.edu.cn.
authors.forename: Yanxun
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China. 596756569@qq.com.
authors.forename: Fangyu
authors.initials: F
authors.lastname: Li
authors.affiliation: The Second Hospital of Shandong University, Jinan, China. jiahongying1969@126.com.
authors.forename: Hongying
authors.initials: H
authors.lastname: Jia
authors.affiliation: Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA. ll85@drexel.edu.
authors.forename: Longjian
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, PO Box 100, Jinan, 250012, China. xuefzh@sdu.edu.cn.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Xue
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult