General Practice and Primary Care - Research Publications

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Author: Khunti, Kamlesh × Author: Webb, David × End date: 2014 × Start date: 2014 ×

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    Body Mass Index and Waist Circumference Cut-Points in Multi-Ethnic Populations from the UK and India: The ADDITION-Leicester, Jaipur Heart Watch and New Delhi Cross-Sectional Studies
    Bodicoat, DH ; Gray, LJ ; Henson, J ; Webb, D ; Guru, A ; Misra, A ; Gupta, R ; Vikram, N ; Sattar, N ; Davies, MJ ; Khunti, K ; Berglund, L (PUBLIC LIBRARY SCIENCE, 2014-03-05)
    AIMS: To derive cut-points for body mass index (BMI) and waist circumference (WC) for minority ethnic groups that are risk equivalent based on endogenous glucose levels to cut-points for white Europeans (BMI 30 kg/m2; WC men 102 cm; WC women 88 cm). MATERIALS AND METHODS: Cross-sectional data from participants aged 40-75 years: 4,672 white and 1,348 migrant South Asian participants from ADDITION-Leicester (UK) and 985 indigenous South Asians from Jaipur Heart Watch/New Delhi studies (India). Cut-points were derived using fractional polynomial models with fasting and 2-hour glucose as outcomes, and ethnicity, objectively-measured BMI/WC, their interaction and age as covariates. RESULTS: Based on fasting glucose, obesity cut-points were 25 kg/m2 (95% Confidence Interval: 24, 26) for migrant South Asian, and 18 kg/m2 (16, 20) for indigenous South Asian populations. For men, WC cut-points were 90 cm (85, 95) for migrant South Asian, and 87 cm (82, 91) for indigenous South Asian populations. For women, WC cut-points were 77 cm (71, 82) for migrant South Asian, and 54 cm (20, 63) for indigenous South Asian populations. Cut-points based on 2-hour glucose were lower than these. CONCLUSIONS: These findings strengthen evidence that health interventions are required at a lower BMI and WC for South Asian individuals. Based on our data and the existing literature, we suggest an obesity threshold of 25 kg/m2 for South Asian individuals, and a very high WC threshold of 90 cm for South Asian men and 77 cm for South Asian women. Further work is required to determine whether lower cut-points are required for indigenous, than migrant, South Asians.