Prevalence Rates of Abdominal Obesity, High Waist-to-Height Ratio and Excess Adiposity, and Their Associated Cardio-Kidney-Metabolic Factors: SIMETAP-AO Study

Abstract

Background/objective: In addition to obesity, adiposity and abdominal obesity (AO) are parameters included in the cardiovascular-kidney-metabolic (CKM) syndrome. However, their prevalence and association with the other CKM factors have been less studied. Our study aimed to determine the prevalence rates of AO, high waist-to-height ratio (WtHR), and excess adiposity (EA), and to compare their associations with CKM factors.

Methods: A cross-sectional observational study was conducted with a random population-based sample of 6,588 study subjects between 18 and 102 years of age. Crude and sex- and age-adjusted prevalence rates of AO, high-WtHR, and EA were calculated, and their associations with CKM variables were assessed by bivariate and multivariate analyses.

Results: The adjusted prevalence rates for AO, high-WtHR, and EA were 39.6% (33.6% in men; 44.9% in women), 30.6% (31.1% in men; 30.6% in women), and 65.6% (65.6% in men; 65.3% in women), respectively, and they increased with age. The main independent factors associated with AO, high-WtHR, and EA were hypertension, diabetes, prediabetes, low HDL-C, hypercholesterolaemia, hypertriglyceridemia, physical inactivity, hyperuricemia, and chronic kidney disease.

Conclusions: Two-thirds of the adult population have EA, one-third have AO, and one-third have high-WtHR. These findings support that the other factors of CKM syndrome, in addition to hyperuricemia and physical inactivity, show an independent association with these adiposity-related variables.

Keywords: abdominal obesity; adiposity; adults; cardiovascular risk factors; prevalence; waist-to-height ratio.

Figure 1

Age-specific prevalence rates of abdominal obesity (A), high-WtHR (B), and excess adiposity (C); n: number of cases; N: sample size; M: male; F: female; p: p-value of the difference in percentages (M vs. F).

Figure 1

Age-specific prevalence rates of abdominal obesity (A), high-WtHR (B), and excess adiposity (C); n: number of cases; N: sample size; M: male; F: female; p: p-value of the difference in percentages (M vs. F).

Figure 2

(A) Comorbidities and medical conditions in populations with and without abdominal obesity and with and without high-WtHR. (B) Comorbidities and medical conditions in populations with and without excess adiposity. ASCVD: atherosclerotic cardiovascular disease; CHD: coronary heart disease; CI: confidence interval; CKD: chronic kidney disease; CVD: cardiovascular disease; eGFR: estimated glomerular filtration rate; HDL-C: high-density lipoprotein cholesterol; OR: odds ratio; PAD: peripheral arterial disease. The definitions of comorbidities or medical conditions are shown in Table S1 (Supplementary Materials).

Figure 2

(A) Comorbidities and medical conditions in populations with and without abdominal obesity and with and without high-WtHR. (B) Comorbidities and medical conditions in populations with and without excess adiposity. ASCVD: atherosclerotic cardiovascular disease; CHD: coronary heart disease; CI: confidence interval; CKD: chronic kidney disease; CVD: cardiovascular disease; eGFR: estimated glomerular filtration rate; HDL-C: high-density lipoprotein cholesterol; OR: odds ratio; PAD: peripheral arterial disease. The definitions of comorbidities or medical conditions are shown in Table S1 (Supplementary Materials).

Figure 3

Multivariate analysis of factors and medical conditions for abdominal obesity (A), high-WtHR (B), and excess adiposity (C). CKD: chronic kidney disease; HDL-C: high-density lipoprotein cholesterol; WtHR: waist-to-height ratio. Definitions of the clinical conditions are shown in Table S1 (Supplementary Materials). ^a OR Exp (β): odds-ratio (95% confidence interval); ^b p: p-value of Wald test with one degree of freedom. CKD: chronic kidney disease; HDL-C: high-density lipoprotein cholesterol. Definitions of the clinical conditions are shown in Table S1 (Supplementary Materials). ^a OR Exp (β): odds-ratio (95% confidence interval); ^b p: p-value of Wald test with one degree of freedom.

Figure 3

Multivariate analysis of factors and medical conditions for abdominal obesity (A), high-WtHR (B), and excess adiposity (C). CKD: chronic kidney disease; HDL-C: high-density lipoprotein cholesterol; WtHR: waist-to-height ratio. Definitions of the clinical conditions are shown in Table S1 (Supplementary Materials). ^a OR Exp (β): odds-ratio (95% confidence interval); ^b p: p-value of Wald test with one degree of freedom. CKD: chronic kidney disease; HDL-C: high-density lipoprotein cholesterol. Definitions of the clinical conditions are shown in Table S1 (Supplementary Materials). ^a OR Exp (β): odds-ratio (95% confidence interval); ^b p: p-value of Wald test with one degree of freedom.