title: Latin American Clinical Epidemiology Network Series - Paper 7: Central obesity measurements better identified risk factors for coronary heart disease risk in the Chilean National Health Survey (2009-2010).
abstract: OBJECTIVE
  Obesity is an important determinant of cardiovascular risk. However, the optimal measure and cutoffs in Latin America are not defined. We sought to assess the relationship between body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with risk factor prevalence and estimated coronary heart disease (CHD) risk and to assess if recommended cutoffs apply to the Chilean population.
  
  
  METHODS
  Data from 2,200 men and 3,216 women from the Chilean Health Survey 2009-2010 were analyzed. Receiver operator characteristic (ROC) curves were used to compare discrimination and estimate optimal cutoffs. Sensitivity, specificity, and net reclassification improvement (NRI) for these cutoffs were compared with values obtained applying international recommendations.
  
  
  RESULTS
  WHtR and WC have a higher ROC area for risk factors and CHD risk. BMI and WC optimal cutoffs did not improve net reclassification when compared with international recommendations. A WHtR of 0.55 in men improves NRI compared with proposed values (P < 0.01). A WHtR of 0.6 in women improves NRI when compared with BMI (P > 0.01) but not when compared with WC.
  
  
  CONCLUSIONS
  Central obesity measurements demonstrated the strongest associations with CV risk factors and estimated risk. Optimal cutoffs were similar to those recommended internationally with the exception of WHtR.
authors.affiliation: Facultad de Medicina, Departamento de Medicina Interna, Universidad de La Frontera, M. Montt 112, Temuco, Chile; Universitat Autònoma de Barcelona, Spain. Electronic address: lanastomas@gmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lanas
authors.affiliation: Facultad de Medicina, Departamento de Medicina Interna, Universidad de La Frontera, M. Montt 112, Temuco, Chile.
authors.forename: Pamela
authors.initials: P
authors.lastname: Serón
authors.affiliation: Facultad de Medicina, Departamento de Medicina Interna, Universidad de La Frontera, M. Montt 112, Temuco, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Muñoz
authors.affiliation: Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Marcoleta 434, Santiago, Chile.
authors.forename: Paula
authors.initials: P
authors.lastname: Margozzini
authors.affiliation: Universitat Autònoma de Barcelona, Spain; Servicio de Epidemiología Clínica y Salud Pública (IIB-Sant Pau), Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Puig
mesh_terms: D015992:Body Mass Index; D002677:Chile; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology*; D016021:Epidemiologic Studies; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D007843:Latin America; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology*; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D055105:Waist Circumference
keywords: Body mass index; Cardiovascular risk; Central obesity; Waist circumference; Waist-to-height ratio