000161850 001__ 161850
000161850 005__ 20251017144559.0
000161850 0247_ $$2doi$$a10.1016/S0140-6736(24)01405-3
000161850 0248_ $$2sideral$$a144510
000161850 037__ $$aART-2024-144510
000161850 041__ $$aeng
000161850 100__ $$aZhou, Bin
000161850 245__ $$aGeneral and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants
000161850 260__ $$c2024
000161850 5060_ $$aAccess copy available to the general public$$fUnrestricted
000161850 5203_ $$aBackground
Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.
Methods
We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).
Findings
The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31–3·28) lower for women and 1·28 kg/m2 (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.
Interpretation
BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions.
000161850 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000161850 590__ $$a88.5$$b2024
000161850 592__ $$a12.113$$b2024
000161850 591__ $$aMEDICINE, GENERAL & INTERNAL$$b1 / 332 = 0.003$$c2024$$dQ1$$eT1
000161850 593__ $$aMedicine (miscellaneous)$$c2024$$dQ1
000161850 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000161850 700__ $$0(orcid)0000-0003-0454-653X$$aMoreno Aznar, L.A.$$uUniversidad de Zaragoza
000161850 7102_ $$11006$$2255$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Enfermería
000161850 773__ $$g404, 10455 (2024), 851-863$$pLancet$$tThe Lancet$$x0140-6736
000161850 8564_ $$s1474983$$uhttps://zaguan.unizar.es/record/161850/files/texto_completo.pdf$$yVersión publicada
000161850 8564_ $$s2842315$$uhttps://zaguan.unizar.es/record/161850/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000161850 909CO $$ooai:zaguan.unizar.es:161850$$particulos$$pdriver
000161850 951__ $$a2025-10-17-14:13:54
000161850 980__ $$aARTICLE