Obesity and its Relation With Diabetes and Hypertension

SHIVANI A. PATEL; VILMA IRAZOLA

global heart

Elsevier

Año: 2016

2211-8160

Background: The implications of rising obesity for cardiovascular health in middle-income countries hasgenerated interest, in part because associations between obesity and cardiovascular health seem to vary acrossethnic groups.Objective: We assessed general and central obesity in Africa, East Asia, South America, and South Asia. Wefurther investigated whether body mass index (BMI) and waist circumference differentially relate tocardiovascular 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 in9 countries, we estimated the proportion of participants with general and central obesity using BMI andwaist circumference classifications, respectively, by study site. We used Poisson regression to examine theassociations (prevalence ratios) of continuously measured BMI and waist circumference with prevalentdiabetes 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 inSouth Asian cities and central obesity was highest in South America. The proportion classified with generalobesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higherprobability 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 associatedwith 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability ofhypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measureswith 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 andhypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metricsof obesity that can identify those with increased cardiovascular risk.