Association of Simple Anthropometric Indices and Body Fat with Early Atherosclerosis and Lipid Profiles in Chinese Adults
et al. (2014) Association of Simple Anthropometric Indices and Body Fat with Early Atherosclerosis and
Lipid Profiles in Chinese Adults. PLoS ONE 9(8): e104361. doi:10.1371/journal.pone.0104361
Association of Simple Anthropometric Indices and Body Fat with Early Atherosclerosis and Lipid Profiles in Chinese Adults
Zhe-qing Zhang 0
Li-ping He 0
Xiao-yan Xie 0
Wen-hua Ling 0
Juan Deng 0
Yi-xiang Su 0
Yu-ming Chen 0
Xiao-Feng Yang, Temple University School of Medicine, United States of America
0 1 Guangdong Provincial Key Laboratory of Food, School of Public Health, Sun Yat-sen University , Guangzhou , People's Republic of China, 2 Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-sen University , Guangzhou , People's Republic of China, 3 Guangzhou Panyu Central Hospital , Guangzhou , People's Republic of China
Objective: The discriminatory capability of different adiposity indices for atherosclerosis and lipid abnormalities remains uncertain. This study aimed to identify the best adiposity index for predicting early atherosclerosis and abnormal lipid profiles among anthropometric parameters and body fat measures in middle-aged and elderly Chinese. Method: A total of 2,063 women and 814 men (57.665.2 y) were recruited for this community-based cross-sectional study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were assessed. Body fat mass and its percentage values for the whole body and trunk were measured by bioelectrical impedance analysis (BIA). The intima-media thicknesses (IMTs) of the common carotid arteries (CCA), internal carotid arteries (ICA) and bifurcation (BIF) were determined via B-mode ultrasound. The fasting lipid profiles were assessed. Results: With per SD increase of adiposity indices, the magnitude of the changes of IMT values and lipid profiles was more substantial for WC, WHR and WHtR in both genders. A multivariate logistic regression analysis indicated that WC, WHR and WHtR were more sensitive in predicting the presence of intima-media thickening at the three segments as well as the lipids disturbances in women and men. In general, BIA-derived measures have no added predictive value for IMT-thickening as opposed to those three traditional abdominal measures. Conclusion: Our findings suggest that abdominal anthropometric measures including WC, WHR and WHtR are sensitive for discriminating carotid atherosclerosis and lipids abnormalities. WC is the best index because of its simplicity in routine use.
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Competing Interests: The authors have declared that no competing interests exist.
. These authors contributed equally to this work.
Introduction
Obesity has been well documented as a major pathological
condition in people predisposed to cardiovascular disease. The
standard epidemiologic translation of this important clinical fact
has been anthropometrically measured. One meta-analysis showed
a 40% increase in vascular-caused mortality for every 5 kg/m2
increase in body mass index (BMI) above 25 kg/m2 [1]. Another
indicated that the relative risk (RR) of a CVD event increased by
2% per 1 cm increase in WC [2]. Despite the clear value of obesity
for CVD diagnostic evaluation, researchers have compared the
discriminatory capability of different adiposity indicators for the
presence of CVD risk, especially between BMI and abdominal
obesity measurements [35]. An appropriate, simple obesity
parameter would be valuable in clinical practice for CVD risk
estimation.
Obesity is defined as a condition of excess fat mass. However,
neither BMI nor body circumference can differentiate fat mass
from lean mass. Many sophisticated methods such as dual-energy
x-ray absorptiometry (DXA), computed tomography (CT) and
magnetic resonance imaging (MRI) have been developed to
provide more precise estimates of the location and amount of
adipose tissue in various body regions [6]. However, technical
difficulties, high costs and a lack of equipment portability limit
their use in routine clinical practice and epidemiologic research at
large. Bioelectrical impedance analysis (BIA) has been considered
a valid alternative for measuring body fat in large studies or
clinical practice due to its low cost and easy application, which has
also been validated against reference methods [7]. It remains
uncertain whether more direct obesity measures have added
incrementally useful information to that provided by simple
anthropometric assessments taken during cardiovascular risk
screenings. A few studies have attempted to address this question
in the context of cardiometabolic risks such as hypertension,
insulin resistance, dyslipidaemia and metabolic syndrome, but the
results are contradictory [8,9].
Accumulative evidence has proved that subclinical vascular
diseases, which could be surrogated by carotid artery wall
intimamedia thickness (IMT), an early manifestation of atherosclerosis,
are strong predictors of futu (...truncated)