Obesity and its Relation with Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions

Shivani A. Patel, Mohammed K. Ali, Dewan Alam, Lijing L. Yan, Naomi S. Levitt, Antonio Bernabe-Ortiz, William Checkley, Yangfeng Wu, Vilma Irazola, Laura Gutierrez, Adolfo Rubinstein, Roopa Shivashankar, Xian Li, J. Jaime Miranda, Muhammad Ashique Haider Chowdhury, Ali Tanweer Siddiquee, Thomas A. Gaziano, M. Masood Kadir, Dorairaj Prabhakaran

Research output: Contribution to journalArticle

Abstract

Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)71-79
Number of pages9
JournalGlobal Heart
Volume11
Issue number1
DOIs
StatePublished - Mar 1 2016

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Waist Circumference
Obesity
Cross-Sectional Studies
Body Mass Index
Hypertension
Abdominal Obesity
South America
Health
South Africa
Far East
Ethnic Groups

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology
  • Community and Home Care

Cite this

Patel, S. A., Ali, M. K., Alam, D., Yan, L. L., Levitt, N. S., Bernabe-Ortiz, A., ... Prabhakaran, D. (2016). Obesity and its Relation with Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions. Global Heart, 11(1), 71-79. https://doi.org/10.1016/j.gheart.2016.01.003

Obesity and its Relation with Diabetes and Hypertension : A Cross-Sectional Study Across 4 Geographical Regions. / Patel, Shivani A.; Ali, Mohammed K.; Alam, Dewan; Yan, Lijing L.; Levitt, Naomi S.; Bernabe-Ortiz, Antonio; Checkley, William; Wu, Yangfeng; Irazola, Vilma; Gutierrez, Laura; Rubinstein, Adolfo; Shivashankar, Roopa; Li, Xian; Miranda, J. Jaime; Chowdhury, Muhammad Ashique Haider; Siddiquee, Ali Tanweer; Gaziano, Thomas A.; Kadir, M. Masood; Prabhakaran, Dorairaj.

In: Global Heart, Vol. 11, No. 1, 01.03.2016, p. 71-79.

Research output: Contribution to journalArticle

Patel, SA, Ali, MK, Alam, D, Yan, LL, Levitt, NS, Bernabe-Ortiz, A, Checkley, W, Wu, Y, Irazola, V, Gutierrez, L, Rubinstein, A, Shivashankar, R, Li, X, Miranda, JJ, Chowdhury, MAH, Siddiquee, AT, Gaziano, TA, Kadir, MM & Prabhakaran, D 2016, 'Obesity and its Relation with Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions', Global Heart, vol. 11, no. 1, pp. 71-79. https://doi.org/10.1016/j.gheart.2016.01.003
Patel, Shivani A. ; Ali, Mohammed K. ; Alam, Dewan ; Yan, Lijing L. ; Levitt, Naomi S. ; Bernabe-Ortiz, Antonio ; Checkley, William ; Wu, Yangfeng ; Irazola, Vilma ; Gutierrez, Laura ; Rubinstein, Adolfo ; Shivashankar, Roopa ; Li, Xian ; Miranda, J. Jaime ; Chowdhury, Muhammad Ashique Haider ; Siddiquee, Ali Tanweer ; Gaziano, Thomas A. ; Kadir, M. Masood ; Prabhakaran, Dorairaj. / Obesity and its Relation with Diabetes and Hypertension : A Cross-Sectional Study Across 4 Geographical Regions. In: Global Heart. 2016 ; Vol. 11, No. 1. pp. 71-79.
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AU - Patel, Shivani A.

AU - Ali, Mohammed K.

AU - Alam, Dewan

AU - Yan, Lijing L.

AU - Levitt, Naomi S.

AU - Bernabe-Ortiz, Antonio

AU - Checkley, William

AU - Wu, Yangfeng

AU - Irazola, Vilma

AU - Gutierrez, Laura

AU - Rubinstein, Adolfo

AU - Shivashankar, Roopa

AU - Li, Xian

AU - Miranda, J. Jaime

AU - Chowdhury, Muhammad Ashique Haider

AU - Siddiquee, Ali Tanweer

AU - Gaziano, Thomas A.

AU - Kadir, M. Masood

AU - Prabhakaran, Dorairaj

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N2 - Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk.

AB - Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk.

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