Elsevier

Metabolism

Volume 52, Issue 10, October 2003, Pages 1295-1301
Metabolism

Modification of the relationship between simple anthropometric indices and risk factors by ethnic background☆

https://doi.org/10.1016/S0026-0495(03)00196-3Get rights and content

Abstract

Current targets for body mass index (BMI) and waist circumference (WC) may not be appropriate for those of South Asian origin. The objectives of this study were to determine whether the relationship between BMI and WC with risk factors for cardiovascular disease (CVD) is the same for men and women of South Asian and European descent. Apparently healthy men and women of European (n = 88) and South Asian (n = 93) descent were recruited from 3 hospital communities and assessed for BMI, WC, waist-to-hip ratio (WHR), blood pressure (BP), lipids, insulin, glucose, and CRP. The study cohort was stratified by sex, and regression analyses were performed with individual risk factors as outcomes and ethnicity with either BMI or WC as predictors adjusting for age and height (WC only). BMI and WC were similar between the European and South Asian men and women. South Asian men had significantly higher values for total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), total cholesterol:high-density lipoprotein-cholesterol (HDL-C) and CRP, and significantly lower values of HDL-C. South Asian women had significantly higher values for TG, TC:HDL-C and CRP and significantly lower values of HDL-C, glucose, systolic BP and diastolic BP. In men, ethnicity was an independent predictor for all risk factors except for glucose and insulin, after adjusting for either BMI or WC independent of age and height. For women, ethnicity was an independent predictor for all risk factors except for total cholesterol (WC model only) and insulin (BMI model only), after adjusting for either BMI or WC independent of age and height. The relationship between BMI or WC and risk factors is such that men and women of South Asian descent present with a more adverse risk profile than those of European descent at the same BMI and/or WC.

Section snippets

Materials and methods

Study participants (men and women) were recruited from staff, students, volunteers, and their friends of 3 local hospitals and the surrounding communities. Apparently healthy participants were eligible if they were over 18 years of age and either of European or South Asian descent. Ethnicity was determined by interview; potential participants were asked the origins of their parents and grandparents. Only those individuals who reported having all known ancestors of either European or South Asian

Results

After excluding smokers and participants taking medications known to affect CVD risk factors, a total of 88 Europeans (35 men and 53 women) and 93 South Asians (34 men and 59 women) were analyzed. Table 1, Table 2 outline the age, anthropometric values, and metabolic risk factors for men and women, respectively. BMI, WC, and WHR were similar between the European and South Asian men and the European and South Asian women. South Asian women were significantly younger, shorter, and had a smaller

Discussion

The presentation of increased body fat is a common predecessor for a number of CVD risk factors. Therefore, targets for BMI and WC are used to identify those at increased risk based on the point at which the risk of mortality is substantially increased, or as a marker for adverse levels of CVD risk factors.4, 12, 25, 26 Our results indicate that ethnic background was a significant modifier of the relationship between both BMI and WC with various CVD risk factors. In particular, ethnicity itself

Acknowledgements

We are indebted to Lida Adler for her work assessing the lipid and glucose measures.

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    ☆

    Supported by the Medical Research Council of Canada and the Heart and Stroke Foundation of Canada (S.A.L.) and the University of British Columbia’s Department of Pathology and Laboratory Medicine (M.T.).

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