Abstract 20073: Waist Circumference is Superior to BMI in Predicting Cardiovascular Risk Factors in a Rural Indigenous Mayan Population in Guatemala
Introduction: Like other developing countries, Guatemala appears to be in epidemiologic transition from infectious diseases to non-communicable diseases such as cardiovascular disease (CVD), underscoring the need to identify and intervene in individuals at high risk. The Non-Communicable Disease Surveillance study is a cross-sectional study that evaluated lifestyle, anthropometric, and biochemical risk factors for CVD in the rural Mayan community of Santiago Atitlan, Guatemala. We aimed to identify the ideal method of assessing adiposity-related CV risk in this unique, predominantly indigenous population with a high degree of stunting (78.5%) and increasing rates of obesity.
Hypothesis: Central obesity as measured by waist circumference (WC) will be a stronger predictor of CV risk factors than BMI in this population.
Methods: We used logistic regression to assess the ability of elevated BMI or WC to predict the presence CVD risk factors (hypertension, hypertriglyceridemia, low HDL, and impaired fasting glucose), controlling for all other CVD risk factors.
Results: Among 350 participants, 290 (83%) had complete data for inclusion in the analysis. Of these 26.7% were obese by BMI and 45.2% by WC. After controlling for age and sex, obesity by BMI and central obesity predicted the presence of CV risk factors. However, after adjustment for all other risk factors, central obesity remained significantly associated with hypertension, low HDL, and impaired fasting glucose whereas obesity by BMI was only associated with hypertriglyceridemia.
Conclusion: This study provides evidence, consistent with other populations, that central obesity is a better predictor of CV risk factors than BMI in this cohort of stunted, indigenous Guatemalans. This has important implications with respect to assessing CV risk in resource-limited areas with stunted populations where, in addition to requiring fewer resources, central obesity by WC may also be a superior measure of CVD risk.
Author Disclosures: D. Chen: None. M. Deboer: None. A. Rivera-Andrade: None. C. Mendoza-Montano: None. D. Burt: None. J. Gonzalez: None. M. Luna: None.
- © 2014 by American Heart Association, Inc.