title: Comparison of body mass index, waist circumference, and waist to height ratio in the prediction of hypertension and diabetes mellitus: Filipino-American women cardiovascular study.
abstract: The relative ability of three obesity indices to predict hypertension (HTN) and diabetes (DM) and the validity of using Asian-specific thresholds of these indices were examined in Filipino-American women (FAW). Filipino-American women (n= 382), 40-65 years of age were screened for hypertension (HTN) and diabetes (DM) in four major US cities. Body mass index (BMI), waist circumference (WC) and waist circumference to height ratio (WHtR) were measured. ROC analyses determined that the three obesity measurements were similar in predicting HTN and DM (AUC: 0.6-0.7). The universal WC threshold of ≥ 35 in. missed 13% of the hypertensive patients and 12% of the diabetic patients. The Asian WC threshold of ≥ 31.5 in. increased detection of HTN and DM but with a high rate of false positives. The traditional BMI ≥ 25 kg/m2threshold missed 35% of those with hypertension and 24% of those with diabetes. The Asian BMI threshold improved detection but resulted in a high rate of false positives. The suggested WHtR cut-off of ≥ 0.5 missed only 1% of those with HTN and 0% of those with DM. The three obesity measurements had similar but modest ability to predict HTN and DM in FAW. Using Asian-specific thresholds increased accuracy but with a high rate of false positives. Whether FAW, especially at older ages, should be encouraged to reach these lower thresholds needs further investigation because of the high false positive rates.
authors.affiliation: University of North Florida, United States.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Battie
authors.affiliation: University of Tennessee Health Science Center, United States.
authors.forename: Nancy
authors.initials: N
authors.lastname: Borja-Hart
authors.affiliation: University of Florida, United States.
authors.forename: Irma B
authors.initials: IB
authors.lastname: Ancheta
authors.affiliation: University of Texas Science Center, United States.
authors.forename: Rene
authors.initials: R
authors.lastname: Flores
authors.affiliation: University of Chicago, North Shore University Health System, United States.
authors.forename: Goutham
authors.initials: G
authors.lastname: Rao
authors.affiliation: Stanford University, United States.
authors.forename: Latha
authors.initials: L
authors.lastname: Palaniappan
keywords: Diabetes; Filipino-American; Hypertension; Obesity; Women