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Association of surrogate and direct measures of adiposity with risk of metabolic syndrome in rural Chinese women

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Abstract

Background

Most studies linking obesity and metabolic syndrome (MS) have used body mass index (BMI) and waist circumference (WC) to measure obesity. While BMI is correlated with direct measures of total and central adiposity, it is influenced by lean body and bone mass. We hypothesize that direct measures of adiposity may help develop further insight into the link between obesity and MS, thus more accurately identifying individuals at high risk for MS.

Aim of the study

We examined how surrogate and direct measures of adiposity were associated with MS risk and if direct adiposity measures enhanced BMI and WC identification of MS risk.

Methods

3,734 Chinese female twins aged 20–39 years were studied. Percent body fat (%BF) and proportion of trunk fat to total BF (%TF) were assessed by DEXA. Graphic plots and generalized estimating equations were used to examine the associations of adiposity measures with MS and its components. Concordance of adiposity measures and MS abnormalities between monozygotic (MZ) and dizygotic (DZ) twin pairs were compared.

Results

The prevalence of MS increased for high BMI (≥23 kg/m2), %BF (≥32), WC (≥80 cm), and (to a lesser degree) %TF (≥50). Below those thresholds, the prevalence of MS was low (0–5.3%). %TF was independently associated with higher risk of MS and its components even after adjusting for BMI and WC. As a result, among women with normal BMI and WC, high %TF was associated with 1.3–2.0-fold elevated risk of MS components. In contrast, women with high BMI but normal WC and %TF neither have significantly increased risk of MS, nor for any component other than high BP. MZ twins showed higher concordance for MS and its components than DZ twins.

Conclusions

In this lean Chinese rural female sample, BMI ≥ 23 and WC ≥ 80 were associated with a markedly increased risk of MS, which was further enhanced by elevated %TF. Even in women with a normal BMI and WC, %TF was independently associated with MS and its components. Twin analysis findings suggest that adiposity measurements and MS risk are influenced by genetics.

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Acknowledgments

This study is supported in part by grant R01 HD049059 from the National Institute of Child Health and Human Development; R01 HL0864619 from the National Heart, Lung, and Blood Institute; R01 AG032227 from the National Institute of Aging; K01 ES012052 from the National Institute of Environmental Health Sciences; and by the Food Allergy Project.

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Authors and Affiliations

  1. Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children’s Memorial Hospital and Children’s Memorial Research Center, Box 157, 2300 Children’s Plaza, Chicago, IL, 60614, USA

    Fengxiu Ouyang, Jonathan Necheles, Binyan Wang, Katherine Kaufer Christoffel & Xiaobin Wang

  2. Division of General Academic Pediatrics, Northwestern University Feinberg School of Medicine and Children’s Memorial Hospital, Chicago, IL, USA

    Jonathan Necheles & Katherine Kaufer Christoffel

  3. Department of Cardiology, Beijing University First Affiliated Hospital, Beijing, China

    Wei Ma

  4. Institute for Biomedicine, Anhui Medical University, Hefei, China

    Zhiping Li, Xue Liu, Genfu Tang & Houxun Xing

  5. Center for Population Genetics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA

    Xiping Xu & Scott A. Venners

  6. Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children’s Memorial Hospital, Chicago, IL, USA

    Wendy J. Brickman & Donald Zimmerman

Authors
  1. Fengxiu Ouyang
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  2. Jonathan Necheles
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  4. Wei Ma
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  7. Genfu Tang
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  8. Houxun Xing
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  9. Xiping Xu
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  12. Katherine Kaufer Christoffel
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  13. Donald Zimmerman
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  14. Xiaobin Wang
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Corresponding author

Correspondence to Xiaobin Wang.

Additional information

Drs. F. Ouyang, J. Necheles, and B. Wang have made equal contribution to this manuscript.

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Ouyang, F., Necheles, J., Wang, B. et al. Association of surrogate and direct measures of adiposity with risk of metabolic syndrome in rural Chinese women. Eur J Nutr 48, 323–332 (2009). https://doi.org/10.1007/s00394-009-0016-z

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