Body mass index and waist circumference cut-points in multi-ethnic populations from the UK and India: the addition-Leicester, Jaipur heart watch and New Delhi cross-sectional studies

Bodicoat, D. H. et al. (2014) Body mass index and waist circumference cut-points in multi-ethnic populations from the UK and India: the addition-Leicester, Jaipur heart watch and New Delhi cross-sectional studies. PLoS ONE, 9(3), e90813. (doi:10.1371/journal.pone.0090813) (PMID:24599391) (PMCID:PMC3944886)

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Abstract

Aims: To derive cut-points for body mass index (BMI) and waist circumference (WC) for minority ethnic groups that are risk equivalent based on endogenous glucose levels to cut-points for white Europeans (BMI 30 kg/m2; WC men 102 cm; WC women 88 cm).

Materials and Methods: Cross-sectional data from participants aged 40–75 years: 4,672 white and 1,348 migrant South Asian participants from ADDITION-Leicester (UK) and 985 indigenous South Asians from Jaipur Heart Watch/New Delhi studies (India). Cut-points were derived using fractional polynomial models with fasting and 2-hour glucose as outcomes, and ethnicity, objectively-measured BMI/WC, their interaction and age as covariates.

Results: Based on fasting glucose, obesity cut-points were 25 kg/m2 (95% Confidence Interval: 24, 26) for migrant South Asian, and 18 kg/m2 (16, 20) for indigenous South Asian populations. For men, WC cut-points were 90 cm (85, 95) for migrant South Asian, and 87 cm (82, 91) for indigenous South Asian populations. For women, WC cut-points were 77 cm (71, 82) for migrant South Asian, and 54 cm (20, 63) for indigenous South Asian populations. Cut-points based on 2-hour glucose were lower than these.

Conclusions: These findings strengthen evidence that health interventions are required at a lower BMI and WC for South Asian individuals. Based on our data and the existing literature, we suggest an obesity threshold of 25 kg/m2 for South Asian individuals, and a very high WC threshold of 90 cm for South Asian men and 77 cm for South Asian women. Further work is required to determine whether lower cut-points are required for indigenous, than migrant, South Asians.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Sattar, Professor Naveed
Authors: Bodicoat, D. H., Gray, L. J., Henson, J., Webb, D., Guru, A., Misra, A., Gupta, R., Vikram, N., Sattar, N., Davies, M. J., and Khunti, K.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN:1932-6203
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in PLoS One 9(3):e90813
Publisher Policy:Reproduced under a Creative Commons License

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