Association of Simple Anthropometric Indices and Body Fat with Early Atherosclerosis and Lipid Profiles in Chinese Adults

PLOS ONE, Dec 2019

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 (57.6±5.2 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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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. - 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)


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Zhe-qing Zhang, Li-ping He, Xiao-yan Xie, Wen-hua Ling, Juan Deng, Yi-xiang Su, Yu-ming Chen. Association of Simple Anthropometric Indices and Body Fat with Early Atherosclerosis and Lipid Profiles in Chinese Adults, PLOS ONE, 2014, Volume 9, Issue 8, DOI: 10.1371/journal.pone.0104361