Dataset Information

BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study.

ABSTRACT:

Objective

This non-inferiority study aimed to determine the burden of obesity in a hospital outpatient setting of a developing country, using three commonly employed metrics as predictors of hypertension (HTN).

Design

A cross-sectional study design was adopted.

Setting

This study was conducted in Health Promotion and Risk Factor Screening Services of a tertiary hospital for eye and ear, nose, throat in a semiurban area of Nepal.

Participants

2256 randomly selected outpatients between 40 and 69 years old.

Outcome measures

The three obesity metrics and HTN were analysed for association using correlation, the area under the receiver operating characteristic (ROC) curve and ORs.

Results

The prevalence of obesity or overweight by body mass index (BMI) was 58.29%; by waist-to-height ratio (WHtR) was 85.95%, high waist circumference (WC) was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of HTN and pre-HTN were 40.67% and 36.77%, respectively. The areas under the ROC curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602) and WC (0.610).

Conclusion

This study showed that WHtR and WC measured were not inferior to BMI as a metric for obesity detection and HTN prediction. Because of its low cost, simplicity of measurement and better ability to predict HTN, it may become a more usable metric in health facilities of low-income and middle-income countries.

SUBMITTER: Shrestha R

PROVIDER: S-EPMC8628118 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study.

Shrestha Rajan R Upadhyay Sanjib Kumar SK Khatri Bijay B Bhattarai Janak Raj JR Kayastha Manish M Upadhyay Madan Prasad MP

BMJ open 20211125 11

<h4>Objective</h4>This non-inferiority study aimed to determine the burden of obesity in a hospital outpatient setting of a developing country, using three commonly employed metrics as predictors of hypertension (HTN).<h4>Design</h4>A cross-sectional study design was adopted.<h4>Setting</h4>This study was conducted in Health Promotion and Risk Factor Screening Services of a tertiary hospital for eye and ear, nose, throat in a semiurban area of Nepal.<h4>Participants</h4>2256 randomly selected ou ...[more]

PMID: 34824112

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Project description:BackgroundThe absolute agreement of surrogate measures of adiposity with dual-energy X-ray absorptiometry (DEXA)-measured body composition was examined.MethodsOver a 15-year follow-up, 7237 (3667 females) nine-year-old children from the Avon Longitudinal Study of Parents and Children (ALSPAC) UK birth cohort were included. Total fat mass (FM) and trunk FM were serially measured with DEXA at ages 9, 11, 15, 17, and 24 years. BMI and waist circumference-to-height ratio (WHtR) were computed. Pearson's correlations, intraclass correlations (ICC), and area under curve (AUC) analyses were conducted.ResultsOver 15 years, BMI, total FM, and trunk FM, increased but WHtR was relatively stable. WHtR provided a better longitudinal absolute agreement [males ICC 0.84 (95% CI 0.84-0.85); females 0.81 (0.80-0.82)] than BMI [(males (0.65 (0.64-0.66); females 0.72 (0.71-0.73)] with total FM as well as trunk FM from ages 9-24 years. WHtR cut-point for predicting excess total FM (75th-95th percentile) was 0.50-0.53 in males [AUC 0.86-0.94, sensitivity 0.51-0.79 and specificity 0.93-0.95]. WHtR cut-point for predicting excess total FM (75th-95th percentile) was 0.52-0.54 in females [AUC 0.83-0.95, sensitivity 0.38-0.68 and specificity 0.92-0.95]. Results were similar with trunk FM.ConclusionWHtR is an inexpensive alternative to BMI for predicting FM in pediatrics.ImpactWaist circumference-to-height ratio (WHtR) is a better adiposity surrogate measure than body mass index (BMI) in predicting fat mass and discriminating lean mass from childhood through young adulthood. BMI has been used as an inexpensive surrogate measure of adiposity in children for several decades. However, emerging findings suggest that BMI fails to discriminate between fat mass adiposity and lean mass. This is the first-ever longitudinal study in over 7000 children followed up for 15 years that identified WHtR as an inexpensive accurate measure that discriminates fat mass from lean mass that could replace BMI measure of obesity in pediatrics.

Project description:BackgroundWaist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are all independent predictors of cardio-metabolic risk and therefore important in HIV/AIDS patients on antiretroviral therapy at risk of increased visceral adiposity. This study aimed to assess the extent of agreement between these parameters and the body mass index (BMI), as anthropometric parameters and in classifying cardio-metabolic risk in HIV/AIDS patients.MethodsA secondary analysis of data from a cross-sectional study involving 200 HIV/AIDS patients was done. Anthropometric parameters were measured from participants using standard guidelines and central obesity defined according to recommended criteria. Increased cardio-metabolic risk was defined according to the standard cut-off values for all four parameters. Data were analyzed using STATA version 14.1.ResultsThe prevalence of WC-defined central obesity, WHR-defined central obesity and WHtR > 0.50 were 33.5%, 44.5% and 36.5%, respectively. The prevalence of BMI-defined overweight and obesity was 40.5%. After adjusting for gender and HAART status, there was a significant linear association and correlation between WC and BMI (regression equation: WC (cm) = 37.184 + 1.756 BMI (Kg/m2) + 0.825 Male + 1.002 HAART, (p < 0.001, r = 0.65)), and between WHtR and BMI (regression equation: WHtR = 0.223 + 0.011 BMI (Kg/m2)- 0.0153 Male + 0.003 HAART, (p < 0.001, r = 0.65)), but not between WHR and BMI (p = 0.097, r = 0.13). There was no agreement between the WC, WHtR and BMI, and minimal agreement between the WHR and BMI, in identifying patients with an increased cardio-metabolic risk.ConclusionDespite the observed linear association and correlation between these anthropometric parameters, the routine use of WC, WHR and WHtR as better predictors of cardio-metabolic risk should be encouraged in these patients, due to their minimal agreement with BMI in identifying HIV/AIDS patients with increased cardio-metabolic risk. HAART status does not appear to significantly affect the association between these anthropometric parameters.

Dataset Information

BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study.

Objective

Design

Setting

Participants

Outcome measures

Results

Conclusion

Publications

BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study.

Similar Datasets

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