Appropriate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Chinese adults

Abstract

Background: Recent data suggest that current overweight and central adiposity guidelines based on Western populations are not appropriate for Asian populations. The published data among Chinese are insufficient to address this issue. Objective: We aimed to identify cutoffs for body mass index (BMI; in kg/m2) and waist circumference that confer increased risk of cardiovascular disease in Chinese adults as would be consistent with overweight and central adiposity. Design: A nationally representative, cross-sectional sample of 15 239 Chinese adults aged 35-74 y was studied. Results: Mean blood pressure, total cholesterol, LDL-cholesterol, triacylglycerol, and glucose values were incrementally higher and mean HDL-cholesterol values were incrementally lower with each unit increase in BMI and waist circumference in both men and women. Both the point at which sensitivity equaled specificity and the shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥2 of these risk factors suggested a BMI cutoff of 24 and a waist circumference cutoff of 80 cm for both men and women. Conclusions: Lower cutoffs for BMI and waist circumference are needed in the identification of Chinese patients at high risk of cardiovascular disease. © 2004 American Society for Clinical Nutrition.