General and abdominal adiposity and hypertension in eight world regions

Autor(en)

, Bin Zhou, James E. Bennett, Aidan P. Wickham, Rosie K. Singleton, Anu Mishra, Rodrigo M. Carrillo-Larco, Nayu Ikeda, Lakshya Jain, Ana Barradas-Pires, Rachel A. Heap, Victor PF Lhoste, Kate E. Sheffer, Nowell H. Phelps, Archie W. Rayner, Edward W. Gregg, Mark Woodward, Gretchen A. Stevens, Maria LC Iurilli, Goodarz Danaei, Mariachiara Di Cesare, Carlos A. Aguilar-Salinas, Noor Ani Ahmad, Pascal Bovet, Zhengming Chen, Albertino Damasceno, Sarah L. Filippi, Imre Janszky, Andre P. Kengne, Young Ho Khang, Kamlesh Khunti, Avula Laxmaiah, Lee Ling Lim, Lauren Lissner, Paula Margozzini, Jean Claude N. Mbanya, Stephen T. McGarvey, Jonathan E. Shaw, Stefan Söderberg, Luis Adrián Soto-Mota, Junyang Wang, Francesco Zaccardi, Leandra Abarca-Gómez, Mohsen Abbasi-Kangevari, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F. Abdul Rahim, Zulfiya Abdurrahmonova, Niveen M. Abu-Rmeileh, Jürgen König, Petra Rust

Abstrakt

Background: Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. Methods: We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. Funding: UK Medical Research Council and UK Research and Innovation (Innovate UK).

Organisation(en)

Department für Ernährungswissenschaften

Journal

The Lancet

Band

404

Seiten

851-863

Anzahl der Seiten

13

ISSN

0140-6736

DOI

https://doi.org/10.1016/S0140-6736(24)01405-3

Publikationsdatum

08-2024

Peer-reviewed

Ja

ÖFOS 2012

303009 Ernährungswissenschaften

ASJC Scopus Sachgebiete

Medicine(all)

Link zum Portal

https://ucrisportal.univie.ac.at/de/publications/general-and-abdominal-adiposity-and-hypertension-in-eight-world-regions(4a9f492e-4a33-48ff-9531-7892f934250c).html