According to overseas media reports, Ian Jensen and colleagues from Queen's University in Canada recently published a report in the *American Journal of Clinical Nutrition* stating that waist circumference is a better predictor of hypertension, hyperlipidemia, and metabolic syndrome than body mass index (BMI). This conclusion was reached after analyzing data from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States.
The census, conducted between 1988 and 1994, surveyed 33,199 individuals. This study, led by Jensen et al., focused on 14,924 individuals whose waist circumference and various metabolic indicators were recorded, who were over 17 years of age, and whose BMI ranged from 18.5 to 34.9. The research investigated the relationship between the incidence of hypertension, hyperlipidemia, and metabolic syndrome and BMI and waist circumference. Hypertension was diagnosed according to US hypertension guidelines, and hyperlipidemia and metabolic syndrome were diagnosed according to US obesity management guidelines.
First, the incidence of the above diseases was compared according to the BMI standards of "normal weight" (18.5-24.9), "overweight" (25-29.9), and "Grade 1 obesity" (30.0-34.9). Compared with the normal weight population, the incidence of hypertension, hypercholesterolemia, low HDL-cholesterolemia, and hypertriglyceridemia (TG) was significantly higher in the overweight and Grade 1 obese populations, regardless of gender. However, the incidence of high HDL-cholesterolemia was significantly higher only in women.
This result has been adjusted for factors such as age, race, smoking status, alcohol consumption, and economic status. If waist circumference is further adjusted, the incidence rate is not significantly increased compared to the normal weight population, except for hypertriglyceridemia in overweight men and hypercholesterolemia in overweight women.
Secondly, a logistic regression analysis was conducted to determine whether BMI and waist circumference could be predictors of the aforementioned diseases. Although both BMI and waist circumference are significant predictors, if both BMI and waist circumference are variables, waist circumference is a significant predictor of all the aforementioned diseases except for hypercholesterolemia and hyperLDL cholesterol in men, while BMI is only a significant predictor of hypertension in men.
Furthermore, regardless of which of the three BMI-based population groups (normal weight, overweight, and grade 1 obesity), as long as waist circumference is the same, the risk of developing other diseases, except for hypertension, hypercholesterolemia, and hyperLDL cholesterol in men, is identical. Jensen et al. believe it is necessary to classify populations based on waist circumference and to verify its usefulness.
