A1 Refereed original research article in a scientific journal

The importance of waist circumference and body mass index in cross-sectional relationships with risk of cardiovascular disease in Vietnam




AuthorsTran NTT, Blizzard CL, Luong KN, Truong NLV, Tran BQ, Otahal P, Nelson M, Magnussen C, Gall S, Bui TV, Srikanth V, Au TB, Hai ST, Phung HN, Tran MH, Callisaya M

PublisherPUBLIC LIBRARY SCIENCE

Publication year2018

JournalPLoS ONE

Journal name in sourcePLOS ONE

Journal acronymPLOS ONE

Article numberARTN e0198202

Volume13

Issue5

Number of pages13

ISSN1932-6203

DOIhttps://doi.org/10.1371/journal.pone.0198202

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/37568914


Abstract
BackgroundWaist circumference (WC) is an indicator of intra-abdominal adipose tissue, high levels of which confer an increased risk of cardiometabolic disease. Population data on WC should be more informative than data on body mass index (BMI), which is a general indicator of body size. This study aimed to evaluate the importance of WC relative to BMI in cross-sectional relationships with blood pressure (BP), glucose, and total cholesterol (TC) in the adult population of Vietnam.MethodsThe data were collected in a population-based survey conducted during 2009-10 using the "WHO STEPwise approach to surveillance of risk factors for non-communicable disease" (STEPS) methodology. The survey participants (n = 14 706 aged 25 to 64 years) were selected by multi-stage stratified cluster sampling from eight provinces representative of the eight geographical regions of Vietnam. All measurements were performed in accordance with the STEPS protocols. All analyses were performed using complex survey methods.ResultsThe measurements of WC and BMI were highly correlated (men r = 0.80, women r = 0.77). For men, the strongest and predominant associations with BP, glucose, and TC were for WC or an index based on WC. For women, this was true for glucose but BMI was more important for BP and TC. WC or an index based on WC provided better discrimination than BMI of hypertension and elevated glucose, and of raised TC for men. Information on four new anthropometric indices did not improve model fit or subject discrimination.ConclusionFor BP/hypertension, glucose/elevated glucose, and TC/raised TC, WC was more informative than BMI for Vietnamese men, but both WC and BMI were important for Vietnamese women. Both WC and BMI need to be assessed for estimation of CVD risk in Vietnam.

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