Comparison of Different Obesity Indices for Predicting Incident Hypertension
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Obesity is well recognized to be an important risk factor for hypertension (HTN), but it is not clear which obesity indices have stronger association with HTN.
To evaluate the ability of different obesity indices, including visceral adiposity index (VAI), hypertriglyceridemic-waist (HTGW) phenotype, a body shape index (ABSI), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) as possible hypertension (HTN) predictor in a high-risk population.
Seven years follow-up data in first-degree relatives of consecutive patients with type 2 diabetes aged 30–70 years without diabetes and HTN with at least one follow-up examination (n = 1417) were analysed. Discriminatory capabilities were examined using the receiver operating characteristic (ROC) curve. Logistic regression analysis was performed to determine the strength of association between obesity indices and HTN.
Among the indices, the highest quintile compared with the lowest quintile of WHtR and WC was more strongly associated with HTN in age and sex adjusted models [odds ratio (95% CI); WHtR: 4.02 (2.36, 6.85) and WC: 3.26 (2.05, 5.20)]. Those with HTGW phenotype was 2.3 (1.54, 3.35) times more likely to develop HTN than those with normal WC normal triglyceride. On ROC curve analysis, WHtR (63.1%; 59.6, 66.7) and WC (61.7%, 58.0, 65.4) had the higher area under the ROC.
Although higher values of VAI, BMI, WHR and HTGW were associated with the risk of HTN, WHtR and WC was more strongly associated with the development of HTN, while the ABSI showed weaker association.
KeywordsVisceral adiposity index Hypertriglyceridemic-waist Hypertension A body shape index Anthropometry First-degree relatives Incidence Risk factor
We thank Mr. M. Abyar for technical computer assistance and all of the participating FDRs. This study was partly funded by the Isfahan University of Medical Sciences, Iran.
MJ designed the study, performed statistical analyses and interpreted the data and drafted the manuscript; AA and MA, recruited samples, contributed to interpretation of results and revised the manuscript. All authors approved the final version submitted for publication.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest concerning this article.
Statement of human and animal rights
This study has been approved by the Isfahan University of Medical Sciences ethical committee.
Informed consent was obtained from all participants for being included in the study.
- 16.Anonymous. Executive summary: standard of medical care in diabetes-2013. Diabetes Care. 2013;36:S4–10.Google Scholar
- 17.James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.CrossRefPubMedGoogle Scholar
- 18.Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;(suppl 1):S5–20.Google Scholar
- 25.XiaoZhen Lv, Hang Y, Zhan S. The predictive value of waist-height ratio to discriminate adult hypertension: a meta-analysis. Chin J Prev Control Chronic Dis. 2009;17:254–7.Google Scholar
- 26.Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P Jr, Razak F, Sharma AM, Anand SS, INTERHEART Study Investigators. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366:1640–9.CrossRefPubMedGoogle Scholar
- 29.Nyamdorj R, Qiao Q, Söderberg S, Pitkäniemi J, Zimmet P, Shaw J, Alberti G, Nan H, Uusitalo U, Pauvaday V, Chitson P, Tuomilehto J. Comparison of body mass index with waist circumference, waist-to-hip ratio, and waist-to-stature ratio as a predictor of hypertension incidence in Mauritius. J Hypertens. 2008;26:866–70.CrossRefPubMedGoogle Scholar
- 35.Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, Vasan RS, Murabito JM, Meigs JB, Cupples LA, D’Agostino RB Sr, O’Donnell CJ. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007;116:39–48.CrossRefPubMedGoogle Scholar
- 37.Oka R, Miura K, Sakurai M, Nakamura K, Yagi K, Miyamoto S, Moriuchi T, Mabuchi H, Koizumi J, Nomura H, Takeda Y, Inazu A, Nohara A, Kawashiri MA, Nagasawa S, Kobayashi J, Yamagishi M. Impacts of visceral adipose tissue and subcutaneous adipose tissue on metabolic risk factors in middle-aged Japanese. Obesity (Silver Spring). 2010;18:153–60.CrossRefGoogle Scholar