Latin American Clinical Epidemiology Network Series – Paper 7: Central obesity measurements better identified risk factors for coronary heart disease risk in the Chilean National Health Survey (2009–2010)

• Published in: Journal of clinical epidemiology 2017-06, Vol.86, p.111-116
• Main Authors: Lanas, Fernando, Serón, Pamela, Muñoz, Sergio, Margozzini, Paula, Puig, Teresa
• Format: Article
• Language: English
• Subjects: Body mass; Body Mass Index; Cardiovascular disease; Cardiovascular diseases; Cardiovascular risk; Central obesity; Chile; Comorbidity; Coronary artery disease; Coronary Disease - epidemiology; Disease prevention; Epidemiologic Studies; Epidemiology; Female; Health risk assessment; Health risks; Health Surveys - statistics & numerical data; Heart; Heart diseases; Humans; Latin America; Male; Men; Middle Aged; Obesity; Obesity, Abdominal - epidemiology; Population studies; Prevalence; Reclassification; Risk analysis; Risk Factors; ROC Curve; Sensitivity and Specificity; Sex Factors; Waist Circumference; Waist-to-height ratio
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2016.04.018

Obesity is an important determinant of cardiovascular risk. However, the optimal measure and cutoffs in Latin America are not defined. We sought to assess the relationship between body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with risk factor prevalence and estimated coronary heart disease (CHD) risk and to assess if recommended cutoffs apply to the Chilean population. Data from 2,200 men and 3,216 women from the Chilean Health Survey 2009–2010 were analyzed. Receiver operator characteristic (ROC) curves were used to compare discrimination and estimate optimal cutoffs. Sensitivity, specificity, and net reclassification improvement (NRI) for these cutoffs were compared with values obtained applying international recommendations. WHtR and WC have a higher ROC area for risk factors and CHD risk. BMI and WC optimal cutoffs did not improve net reclassification when compared with international recommendations. A WHtR of 0.55 in men improves NRI compared with proposed values (P  0.01) but not when compared with WC. Central obesity measurements demonstrated the strongest associations with CV risk factors and estimated risk. Optimal cutoffs were similar to those recommended internationally with the exception of WHtR.