Study to assess predictive value of waist to height ratio and body mass index as a risk factor of hypertension and type 2 diabetes mellitus
Keywords:Hypertension, Diabetes mellitus, Body mass index, Waist to height ratio
Background: Hypertension and diabetes have become important world-wide public-health challenges. Assessment of risk for Hypertension and Diabetes requires identifying an easy tool that can be used by health workers in screening programmes. To compare predictive value of WHtR against BMI in assessing risk of Hypertension and Diabetes.
Methods: A case-control study was carried out at MB Hospital and Urban Health Training Centre (UHTC) attached to RNT Medical College, Udaipur, Rajasthan. Selected individuals were examined and interviewed using semi-structured questionnaire. Anthropometric measurements were carried out. Odds ratios were derived for quantitative analysis.
Results: Observed proportion of BMI ≥ 25 kg /m2 was 60.4% in type 2 diabetes cases, whereas 39.6% in controls. Odds ratio was 2.383. Observed proportion of BMI ≥ 25 kg/ m2 was 66.7% in HTN cases, whereas 33.3% in controls with a Odds ratio of 3.484. An Odds ratio of 3.151, showed existence of strong association of WHtR above 0.5 with hypertension. Observed proportion of WHtR above 0.5 was 56.3% in type 2 diabetes cases, whereas 43.7% in controls and Odds ratio was 4.292.
Conclusions: The OR of WHtR in diabetes (4.292) in compared to OR of BMI (2.303), shows the strength of association of WHtR as an alarming risk factor for diabetes than BMI; whereas an equivalent strength of association was observed for hypertension. Study favours the use of anthropometric measures especially WHtR for predicting type 2 diabetes mellitus and hypertension.
Report on a symposium, Amsterdam. The Public Health Aspects of Chronic Diseases. EURO, WHO. Copenhagen: 1956: 9.
He J, Whelton PK. Epidemiology and prevention of hypertension. Med Clin North Am. 1997;81:1077-97.
Whelton PK. Epidemiology of hypertension. Lancet. 1994;344:101-06.
WHO (2012), World Health Statistic, 2012.
WHO (2011), Global Status Report on Non-Communicable Diseases, 2010.
Sidhu S, Kumari K, Prabhjot. Socio-demographic variables of hypertension among adult Punjabi females. J Hum Ecol. 2005;17(3):211-5.
Praso S, Jusupovic F, Ramic E, Gledo I, Ferkovic V, Novakovic B, et al. Obesity as a risk factor for arterial hypertension. Mat Soc Med. 2012;24(2):87-90.
Bhandary S, Malik SL, Risal P, Koju R. Waist circumference and waist-hip ratio as predictors of type 2 diabetes mellitus in the Nepalese population of Kavre District, Nepal. Med Coll J. 2009;11(4):261-7.
Chobanion AV, Bakris GL, Black HR. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure, the JNC 7 report. JAMA. 2003;289:2560-72.
Park K. Textbook of preventive and social medicine’. 22nd ed. M.S. Banarsidas Bhanot Publisher; 2013: 369-70.
WHO (2003), Tech. Repo. Ser. No.916. Available at http://www.who.int/dietphysicalactivity/Publications/trs916/en/. Accessed on 26 January 2014.
Prevention and Control of Non-communicable Disease: Guidelines for Primary health care in low-resource settings. WHO, 2012.
Garrison R, Kannel W, Strokes J, Castelli W. Incidence and precursors of hypertension in young adults. The Framingham offspring study. Am J Prev Med. 1987;16:235-51.
Mishra S, Wasir HS. Obesity as a Risk Factor for Coronary Artery Disease. JAPI. 1997;45(7):555-8.
Zhang Z, Deng J, He L, Ling W, Su Y, Chen Y. Comparison of Various Anthropometric and Body Fat Indices in Identifying Cardio-metabolic Disturbances in Chinese Men and Women. PLoS One. 2013;8(8):70893.
Li W, Chen W, Chang Y, Seng Loke S, Hao Wang S, Yu Hsiao K. Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among Taiwanese adults. Eur J Nutr. 2013;52(1):57–65.