[Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population]

Abstract

Objective: For prevention of obesity in Chinese population, it is necessary to define the optimal range of healthy weight and the appropriate cut-off points of body mass index (BMI) and waist circumference for Chinese adults. The Working Group on Obesity in China (WGOC) under the support of International Life Sciences Institute Focal point in China organized a meta-analysis on the relation between BMI, waist circumference and risk factors of related chronic diseases.

Methods: All together 13 population studies met the criteria for enrollment, with data of 239 972 adults (20 - 70 year) surveyed in the 1990s. Data on waist circumference was available for 111 411 persons and data on serum lipids and glucose were available for more than 80 000. The study populations located in 21 provinces, municipalities and autonomous regions in mainland China as well as in Taiwan. Each enrolled study group provided data according to a common protocol and uniform format. The center for data management in the Department of Epidemiology, Fu Wai Hospital was responsible for statistical analysis.

Results: The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all increased with increasing levels of BMI or waist circumference. BMI at 24 with best sensitivity and specificity for identification of the risk factors, was recommended as the cut-off point for overweight since and BMI at 28 which might identify the risk factors with specificity around 90% to be recommended as the cut-off point for obesity. Waist circumference beyond 85 cm for men and beyond 80 cm for women were recommended as the cut-off points for central obesity.

Conclusions: Analysis of population attributable risk percent illustrated that reducing BMI to normal range (< 24) could prevent 45% - 50% clustering of risk factors. Treatment of obese persons (BMI >/= 28) with drugs could prevent 15% - 17% clustering of risk factors. Control the waist circumference under 85 cm for men and under 80 cm for women, could prevent 47% - 58% clustering of risk factors.