Derivation of anthropometric cut-off levels to define CVD risk in Sri Lankan adults

• Published in: British journal of nutrition 2011-04, Vol.105 (7), p.1084-1090
• Main Authors: Katulanda, P, Jayawardena, M.A.R, Sheriff, M.H.R, Matthews, D.R
• Format: Article
• Language: English
• Subjects: Adult; adults; Anthropometry; Asian Continental Ancestry Group; Biological and medical sciences; blood; Blood pressure; Body Mass Index; Cardiovascular disease; Cardiovascular Diseases - ethnology; Cardiovascular Diseases - etiology; Epidemiology; European Continental Ancestry Group; fasting; Feeding. Feeding behavior; Female; Females; Fundamental and applied biological sciences. Psychology; glucose; glucose tolerance; Health risks; high density lipoprotein cholesterol; Humans; Male; Males; men; Middle Aged; Minority & ethnic groups; Nutrition research; Obesity; Obesity - complications; Obesity - ethnology; Reference Values; risk; Risk Factors; ROC Curve; Sex Factors; Sri Lanka; Vertebrates: anatomy and physiology, studies on body, several organs or systems; waist circumference; Waist Circumference - ethnology; Waist-Hip Ratio; waist-to-hip ratio; Whites; women
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114510004563

Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative sample of 4474 non-institutionalised adults aged ≥ 18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood samples were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors (P < 0·001). Cut-off values for BMI, WC and WHR for males were 20·7 kg/m2, 76·5 cm and 0·89, respectively. The respective values for females were 22·0 kg/m2, 76·3 cm and 0·85. The common cut-off value for BMI for males and females was 21·5 kg/m2. Similarly, WC and WHR cut-off values for both males and females were 76·3 cm and 0·87, respectively. The Asian and Caucasian anthropometric cut-off levels showed lower sensitivity and higher false negative percentage compared with newly derived cut-off levels. In conclusion, BMI, WC and WHR were all associated with increased CVD risk. We propose the following anthropometric cut-off points to determine high CVD risk level for Sri Lankan adults: BMI ≥ 21·5 kg/m2, WC ≥ 76 cm and WHR ≥ 0·85 (women) and 0·90 (men).