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Predictive values of waist circumference for dyslipidemia, type 2 diabetes and hypertension in overweight White, Black, and Hispanic American adults.

Abstract

Waist circumferences (WC) >/=102 cm for men and >/=88 cm for women have been proposed by an expert panel as cut-points for identifying increased risk for the development of obesity comorbidities for most adults. The aim of this investigation was to examine the predictive values of these WC cut-points for hypercholesterolemia, low concentration of high (HDL-C), and high concentration of low (LDL-C) density lipoprotein cholesterol, hypertriglyceridemia, type 2 diabetes, and hypertension in overweight American adults. Data from NHANES III were utilized for the analysis. Predictive abilities were determined by calculating sensitivity, specificity, positive (PV+) and negative (PV-) predictive values in overweight subjects with BMI 25-29.9 kg/m(2). Sensitivity of WC cut-point was stronger for high LDL-C compared to other risk factors with the highest values recorded in the 40-59 and 60-69 year age groups in men and women, respectively. PV+ of WC cut-points for dyslipidemia, type 2 diabetes, and hypertension were low in men compared to women. PV+ tended to increase with age, from 19-39, 40-59 to 60-90 year age groups in Whites, Blacks, and Hispanic men. In men, the highest PV+ were recorded for hypertriglyceridemia in the 60-90 years old groups, with values of 71.6%, 52.5%, and 43.3% in Whites, Blacks, and Hispanics, respectively. The CVD risk factor associated with the highest PV+ in women was diabetes with values of 97.2% in Whites and 88.9% in Blacks, and hypertriglyceridemia with a value of 93.8% in the 17-39 year age group in Hispanics. Among Black men 40-59 years of age, only 32% of a population of overweight hypertensives were detected by the WC cut-points, and among Black women, 40-59 years of age, only 54% were detected. Given the low sensitivity of these cut-points for detecting hypertension, one of the major co-morbidities of obesity, these cut-points failed to provide adequate evidence for the use of WC in determining or evaluating patients as to co-morbid states. We recommend further studies to determine a set of specific cut-points associated with increased risk of CVD in different population groups.

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  • Authors+Show Affiliations

    ,

    Department of Community Medicine, Mercer University School of Medicine, Macon, GA 31207-0001, USA.

    , , ,

    Source

    Journal of clinical epidemiology 53:4 2000 Apr pg 401-8

    MeSH

    Adolescent
    Adult
    African Continental Ancestry Group
    Age Distribution
    Aged
    Aged, 80 and over
    Body Mass Index
    Diabetes Mellitus
    Diabetes Mellitus, Type 2
    European Continental Ancestry Group
    Female
    Hispanic Americans
    Humans
    Hyperlipidemias
    Hypertension
    Male
    Middle Aged
    Obesity
    Prevalence
    Prognosis
    Risk Factors
    Sensitivity and Specificity
    United States

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10785571

    Citation

    Okosun, I S., et al. "Predictive Values of Waist Circumference for Dyslipidemia, Type 2 Diabetes and Hypertension in Overweight White, Black, and Hispanic American Adults." Journal of Clinical Epidemiology, vol. 53, no. 4, 2000, pp. 401-8.
    Okosun IS, Liao Y, Rotimi CN, et al. Predictive values of waist circumference for dyslipidemia, type 2 diabetes and hypertension in overweight White, Black, and Hispanic American adults. J Clin Epidemiol. 2000;53(4):401-8.
    Okosun, I. S., Liao, Y., Rotimi, C. N., Choi, S., & Cooper, R. S. (2000). Predictive values of waist circumference for dyslipidemia, type 2 diabetes and hypertension in overweight White, Black, and Hispanic American adults. Journal of Clinical Epidemiology, 53(4), pp. 401-8.
    Okosun IS, et al. Predictive Values of Waist Circumference for Dyslipidemia, Type 2 Diabetes and Hypertension in Overweight White, Black, and Hispanic American Adults. J Clin Epidemiol. 2000;53(4):401-8. PubMed PMID: 10785571.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Predictive values of waist circumference for dyslipidemia, type 2 diabetes and hypertension in overweight White, Black, and Hispanic American adults. AU - Okosun,I S, AU - Liao,Y, AU - Rotimi,C N, AU - Choi,S, AU - Cooper,R S, PY - 2000/4/29/pubmed PY - 2000/6/8/medline PY - 2000/4/29/entrez SP - 401 EP - 8 JF - Journal of clinical epidemiology JO - J Clin Epidemiol VL - 53 IS - 4 N2 - Waist circumferences (WC) >/=102 cm for men and >/=88 cm for women have been proposed by an expert panel as cut-points for identifying increased risk for the development of obesity comorbidities for most adults. The aim of this investigation was to examine the predictive values of these WC cut-points for hypercholesterolemia, low concentration of high (HDL-C), and high concentration of low (LDL-C) density lipoprotein cholesterol, hypertriglyceridemia, type 2 diabetes, and hypertension in overweight American adults. Data from NHANES III were utilized for the analysis. Predictive abilities were determined by calculating sensitivity, specificity, positive (PV+) and negative (PV-) predictive values in overweight subjects with BMI 25-29.9 kg/m(2). Sensitivity of WC cut-point was stronger for high LDL-C compared to other risk factors with the highest values recorded in the 40-59 and 60-69 year age groups in men and women, respectively. PV+ of WC cut-points for dyslipidemia, type 2 diabetes, and hypertension were low in men compared to women. PV+ tended to increase with age, from 19-39, 40-59 to 60-90 year age groups in Whites, Blacks, and Hispanic men. In men, the highest PV+ were recorded for hypertriglyceridemia in the 60-90 years old groups, with values of 71.6%, 52.5%, and 43.3% in Whites, Blacks, and Hispanics, respectively. The CVD risk factor associated with the highest PV+ in women was diabetes with values of 97.2% in Whites and 88.9% in Blacks, and hypertriglyceridemia with a value of 93.8% in the 17-39 year age group in Hispanics. Among Black men 40-59 years of age, only 32% of a population of overweight hypertensives were detected by the WC cut-points, and among Black women, 40-59 years of age, only 54% were detected. Given the low sensitivity of these cut-points for detecting hypertension, one of the major co-morbidities of obesity, these cut-points failed to provide adequate evidence for the use of WC in determining or evaluating patients as to co-morbid states. We recommend further studies to determine a set of specific cut-points associated with increased risk of CVD in different population groups. SN - 0895-4356 UR - https://www.unboundmedicine.com/medline/citation/10785571/Predictive_values_of_waist_circumference_for_dyslipidemia_type_2_diabetes_and_hypertension_in_overweight_White_Black_and_Hispanic_American_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0895-4356(99)00217-6 DB - PRIME DP - Unbound Medicine ER -