Hip circumference and incident metabolic risk factors in Chinese men and women: the People's Republic of China study

Abstract

Background: The associations between adiposity and metabolic risk factors have been suggested to vary across ethnicities. Studies in Caucasians have shown that after adjusting for waist circumference and body mass index (BMI), a larger hip circumference may be protective for metabolic risk factors. To our knowledge, these associations have never been examined in a Chinese population.

Methods: Baseline (1987-1988) and follow-up (1993-1994) data were from the People's Republic of China Study (n = 1,144 men, n = 1,776 women). Logistic models were stratified by sex and adjusted for age, smoking, center, and education. Incidence differences (ID) comparing the sex specific 85(th) percentile to the 15(th) percentile of hip circumference were computed for elevated blood pressure, blood glucose and triglycerides, low high-density lipoprotein cholesterol (HDL-C), and multiple metabolic abnormalities (three or more of the aforementioned).

Results: In models adjusted for waist circumference and BMI, the ID [95% confidence interval (CI)] per 1,000 persons associated with a 12-cm larger hip were -132 (-237, -26) for low HDL-C; -85 (-138, -31) for elevated triglycerides; and -49 (-83, -4) for multiple metabolic abnormalities. In males, a larger hip circumference was not associated with a reduction of incident risk factors, although the ID tended to be negative.

Conclusions: In Chinese women, greater mass in the lower trunk region was inversely associated with incident high triglycerides, low HDL-C, and multiple metabolic abnormalities when adjusted for general and central adiposity. This association was not detected in men. Additional research is needed to better understand the mechanisms by which fat at different depots results in differential risk.

FIG. 1.

(A) Incidence difference [95% confidence interval (CI)] per 1,000 persons for metabolic abnormalities at the 15th versus 85th percentile of hip circumference in women. All models were adjusted for baseline age, age2, education level, smoking status, and field center. Multiple metabolic abnormalities were defined as the presence of three or more metabolic abnormalities [elevated blood pressure, elevated glucose, low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides]. The 15th and 85th percentiles of hip were 82 cm and 94 cm, respectively. (B) Incidence difference (95% CI) per 1,000 persons for metabolic abnormalities at the 15th versus 85th percentile of hip circumference in men. All models were adjusted for baseline age, education level, smoking status, and field center. Multiple metabolic abnormalities were defined as the presence of three or more metabolic abnormalities (elevated blood pressure, elevated glucose, low HDL-C, and elevated triglycerides). The 15th and 85th percentiles of hip were 82 cm and 93 cm, respectively.

FIG. 1.

(A) Incidence difference [95% confidence interval (CI)] per 1,000 persons for metabolic abnormalities at the 15th versus 85th percentile of hip circumference in women. All models were adjusted for baseline age, age2, education level, smoking status, and field center. Multiple metabolic abnormalities were defined as the presence of three or more metabolic abnormalities [elevated blood pressure, elevated glucose, low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides]. The 15th and 85th percentiles of hip were 82 cm and 94 cm, respectively. (B) Incidence difference (95% CI) per 1,000 persons for metabolic abnormalities at the 15th versus 85th percentile of hip circumference in men. All models were adjusted for baseline age, education level, smoking status, and field center. Multiple metabolic abnormalities were defined as the presence of three or more metabolic abnormalities (elevated blood pressure, elevated glucose, low HDL-C, and elevated triglycerides). The 15th and 85th percentiles of hip were 82 cm and 93 cm, respectively.