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A comparison of anthropometric indices for predicting hypertension and type 2 diabetes in a male industrial population of Chennai, South India.

OBJECTIVES
To assess the association of four obesity-related indices--body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR)--with hypertension and type 2 diabetes among a male industrial population in south India.


DESIGN, SETTING, AND PARTICIPANTS
A cross sectional study of 2148 men aged 18-69 years in two purposely selected industrial units in Chennai, India, in 2003-2005.


MAIN OUTCOME MEASURES
The examination included blood pressure and anthropometric measurements (height, weight, hip circumference, and WC) to calculate BMI, WHR, and WSR. Fasting blood samples were taken to assess plasma glucose.


RESULTS
Prevalence of overweight was 43.4%; prevalences of central obesity using WC > or = 90.0 cm and WHR > 0.90 were 50.0% and 70%, respectively. The prevalences of hypertension and type 2 diabetes were 26.5% and 16.3%, respectively. There was a significant increase in the prevalence of type 2 diabetes and hypertension across the quintiles for the four anthropometric indices. In logistic regression analysis, BMI and WC showed a significant graded increase in the odds ratio for hypertension after adjusting for age. In case of type 2 diabetes, only WHR showed significant increase in odds ratio across quintiles after adjusting for age and BMI.


CONCLUSIONS
WHR was the best predictor for type 2 diabetes in the study sample. BMI and WC were good predictors for hypertension. We recommend that WHR should be routinely used in this clinical setting in addition to BMI to detect persons at high risk in these industrial units. Prospective studies are needed to provide evidence of the predictive power of anthropometric indices for Asian Indians.