TY - JOUR
T1 - Obesity and its Relation with Diabetes and Hypertension
T2 - A Cross-Sectional Study Across 4 Geographical Regions
AU - Patel, Shivani A.
AU - Ali, Mohammed K.
AU - Alam, Dewan
AU - Yan, Lijing L.
AU - Levitt, Naomi S.
AU - Bernabe-Ortiz, Antonio
AU - Checkley, William
AU - Wu, Yangfeng
AU - Irazola, Vilma
AU - Gutierrez, Laura
AU - Rubinstein, Adolfo
AU - Shivashankar, Roopa
AU - Li, Xian
AU - Miranda, J. Jaime
AU - Chowdhury, Muhammad Ashique Haider
AU - Siddiquee, Ali Tanweer
AU - Gaziano, Thomas A.
AU - Kadir, M. Masood
AU - Prabhakaran, Dorairaj
N1 - Funding Information:
This project has been funded in part by federal funds from the U.S. National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN268200900029C (Argentina), HHSN26820900032C (Bangladesh), HHSN268200900027C (China), HHSN268200900026C (India, New Delhi), and HHSN268200900033C (Peru). South Africa data collection was supported by an unrestricted grant from Servier Laboratories (South Africa); the Medical Research Council of South Africa; the Initiative for Cardiovascular Health Research in Developing Countries (IC Health) Foundation Council; and Brigham Women's Hospital and Harvard University. Antonio Bernabe-Ortiz is a Research Training Fellow in Public Health and Tropical Medicine funded by Wellcome Trust (103994/Z/14/Z). The funding source played no role in the study design, data collection, data analysis and interpretation, or writing of the report. The funding source contractually required review and approval of the manuscript prior to submission for publication and no changes were requested.
Publisher Copyright:
© 2016 World Heart Federation (Geneva).
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk.
AB - Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk.
UR - http://www.scopus.com/inward/record.url?scp=84963851463&partnerID=8YFLogxK
U2 - 10.1016/j.gheart.2016.01.003
DO - 10.1016/j.gheart.2016.01.003
M3 - Article
C2 - 27102024
AN - SCOPUS:84963851463
SN - 2211-8160
VL - 11
SP - 71-79.e4
JO - Global Heart
JF - Global Heart
IS - 1
ER -
