OBJECTIVETo understand the distributions of waist circumference and waist-to-height ratio (WHtR) in Han and Uygur ethnic children aged 3-9 years in Xinjiang Uygur Autonomous Region (Xinjiang) and discuss their values in obesity screening in children.

METHODSStratified cluster random sampling was conducted to select Han and Uygur ethnic children from kindergartens and primary schools in four areas of Xinjiang in April 2014. The children's standing height, body weight and waist circumference were measured by trained investigators according to standard protocol. WC>or=P80 and WHtR>or=0.48 were used as the cutoff value for abdominal obesity screening in children with normal BMI. The association between overweight/obese prevalence rate and obesity related indicators, such as BMI, WC, WHtR, were analyzed.

RESULTSA total of 4024 Han and Uygur ethnic children were investigated, in which 2461 were in Han ethnic group, 1563 were in Uygur ethnic group. The WC and WHtR at P50 and P80 were differed significantly. In both Han and Uygur ethnic groups, there were some children with WC>or=P80 or WHtR>or=0.48, although they had normal BMI. This proportion decreased with age.

CONCLUSIONSThe WC and WHtR are similar in Han and Uygur ethnic children aged 3-9 years. WC and WHtR have values in obesity screening for children with normal BMI which suggested to use it as the supplementation of BMI in obesity screening in preschool aged children.

Body Height ; Child ; Child, Preschool ; China ; epidemiology ; Ethnic Groups ; Humans ; Mass Screening ; Obesity, Abdominal ; Overweight ; ethnology ; Pediatric Obesity ; ethnology ; Prevalence ; Schools ; Waist Circumference ; Waist-Height Ratio

Objective: To analyze the epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years. Methods: Data was from the samples of aged 6-17 years in the China National Nutrition and Health Surveillance program in 2010-2012. P(90) (the same age, the same sex) was used as the diagnostic value for abdominal obesity. Results: The overall waist circumference of children and adolescents in all the age groups appeared higher in males than that in females (P<0.000 1), higher in cities than that in the rural areas (P<0.05), and higher in children with high family income than those with middle or low family incomes (P=0.000 3). The rate of abdominal obesity in children and adolescents aged 6-17 years appeared as 11.2% on average and 10.7% and 11.8% for boys and girls, respectively but with no significant difference (P>0.05). Rates on abdominal obesity appeared as 13.2% and 8.5% for boys while as 12.3% and 11.2% for girls respectively, in urban or rural areas. As for the levels of family income, the abdominal obesity rates appeared as 15.8%, 11.5% and 8.8% respectively for boys while 13.5%, 11.9% and 11.6% respectively for girls, under high, middle and low levels of family income. Conclusion: The rate of abdominal obesity in boys seemed more responsive to the impact of income in urban or rural areas.
Adolescent ; Asian People/statistics & numerical data* ; Child ; China/epidemiology* ; Cities ; Female ; Humans ; Male ; Obesity, Abdominal/ethnology* ; Prevalence ; Waist Circumference

OBJECTIVETo study blood pressure levels, the prevalence of hypertension and factors associated with the development of hypertension in Hasakh children in the Yili region of Xinjiang Province.

METHODSA total of 2438 Hasakh school children from the Yili region of Xinjiang Province were sampled by stratified random cluster sampling method between May and June 2009. Height, weight, waist circumference, hip circumference, skinfold thickness and blood pressure were measured. Body mass index (BMI) was calculated.

RESULTSMean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 94±13 mm Hg and 60±9 mm Hg respectively in the 2438 children, and both averages were lower than in the Han children. Hypertension was noted in 138 children (5.66%). The prevalence of hypertension in girls (6.97%, 84/1206) was higher than in boys (4.38%, 54/1232) (P<0.05). The prevalence of hypertension and blood pressone were positively correlated with BMI, waist circumference, hip circumference, skinfold thickness circumference, gender and age.

CONCLUSIONSAverage blood pressure levels in Hasakh children in the Yili region of Xinjiang Province are lower than in domestic age-matched Han children. The prevalence of hypertension in girls is higher than in boys. Obesity is highly correlated with the development of hypertension.

Adolescent ; Blood Pressure ; Body Mass Index ; Child ; China ; epidemiology ; ethnology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Male ; Obesity ; physiopathology ; Prevalence ; Risk Factors ; Skinfold Thickness ; Waist Circumference

PURPOSE: The aim of this study was to study the appropriate cut-off value of visceral fat area (VFA) and waist-to-height ratio (WTHR) which increase the risk of obesity-related disorders and to validate the diagnostic criteria of abdominal obesity and metabolic syndrome in Korean children and adolescents. MATERIALS AND METHODS: A total 314 subjects (131 boys and 183 girls) were included in this study. The subjects were selected from Korean children and adolescents who visited three University hospitals in Seoul and Uijeongbu from January 1999 to December 2009. All patients underwent computed tomography to measure VFA. RESULTS: The cut-off value of VFA associated with an increase risk of obesity-related disorder, according to the receiver operating characteristics curve, was 68.57 cm2 (sensitivity 59.8%, specificity 76.6%, p=0.01) for age between 10 to 15 years, and 71.10 cm2 (sensitivity 72.3%, specificity 76.5%, p<0.001) for age between 16 to 18 years. By simple regression analysis, the WTHR corresponding to a VFA of 68.57 cm2 was 0.54 for boys and 0.61 for girls, and the WTHR corresponding to a VFA of 71.10 cm2 was 0.51 for boys and 0.56 for girls (p=0.004 for boys, p<0.001 for girls). CONCLUSION: Based on the results of this study, VFA which increases the risk of obesity-related disorders was 68.57 cm2 and the WTHR corresponding to this VFA was 0.54 for boys and 0.61 for girls age between 10-15 years, 71.70 cm2 and the WTHR 0.51 for boys and 0.56 for girls age between 16-18 years. For appropriate diagnostic criteria of abdominal obesity and obesity-related disorders in Korean children and adolescents, further studies are required.
Adolescent ; Asian Continental Ancestry Group/*statistics & numerical data ; *Body Height ; Child ; Female ; Humans ; Intra-Abdominal Fat/*pathology ; Male ; Metabolic Syndrome X/ethnology/pathology ; Obesity/*ethnology/*pathology ; Republic of Korea/epidemiology ; Risk Factors ; *Waist Circumference

Objective: To evaluate the association of educational level with anthropometric measurements at different adult stages and their long-term changes in adults who participated in the second re-survey of China Kadoorie Biobank (CKB). Methods: The present study excluded participants who were aged >65 years, with incomplete or extreme measurement values, or with major chronic diseases at baseline survey or re-survey. The weight at age 25 years was self-reported. Body height, body weight and waist circumference at baseline survey (2004-2008) and re-survey (2013-2014) were analyzed. Results: The present study included 3 427 men and 6 320 women. Both body weight and waist circumference (WC) increased with age. From age 25 years to baseline survey (mean age 45.2±6.5), the mean weight change per 5-year was (1.70±2.63) kg for men and (1.27±2.10) kg for women. From baseline survey to re-survey (53.2±6.5), the mean changes per 5-year for body weight were (1.12±2.61) kg for men and (0.90±2.54) kg for women; and that for WC was (3.20±3.79) cm for men and (3.83±3.85) cm for women. Among women, low educational level was consistently associated with higher body mass index (BMI) and WC at age 25 years, baseline survey and re-survey. Among men, low educational level was associated with higher BMI at age 25 years. At baseline survey and re-survey, the educational level in men was not statistically associated with BMI; but men who completed junior or senior high school showed slight higher WC and increase of WC from baseline survey to re-survey than other male participants. Conclusions: Body weight and WC increased with age for both men and women. The associations of educational level with BMI and WC were different between men and women.
Adult ; Asian People/statistics & numerical data* ; Body Height ; Body Mass Index ; Body Weight ; China/epidemiology* ; Educational Status ; Female ; Humans ; Male ; Middle Aged ; Obesity/ethnology* ; Risk Factors ; Sex Distribution ; Waist Circumference/ethnology*

Objective: To explore the effect of BMI and waist circumference on diabetes of adults. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited. Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes. Results: Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years), a total of 944 men and 1 643 women were diagnosed as having diabetes. Compared to those with normal weight, after adjusting for known or potential factors, HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95%CI: 2.47-2.99) and 6.27 (95%CI: 5.33-7.36), respectively. The corresponding figures in women were 2.19 (95%CI: 2.04-2.36) and 3.78 (95%CI: 3.36-4.26). Compared to those with normal waist circumference, after adjusting for known or potential factors, HR of Ⅰgrade andⅡgrade in men for diabetes were 2.56 (95%CI: 2.22-2.95) and 4.66 (95%CI: 4.14-5.24), respectively. The corresponding figures in women were 1.99 (95%CI: 1.80-2.21) and 3.16 (95%CI: 2.90-3.44), respectively. Conclusions: Overweight, obesity and central obesity were all associated with the increased incident of diabetes. Strategies on diabetes prevention should include not only losing weight, but reducing waist circumference as well.
Adult ; Aged ; Body Mass Index ; China/epidemiology* ; Diabetes Mellitus/ethnology* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Obesity/epidemiology* ; Obesity, Abdominal/epidemiology* ; Overweight/epidemiology* ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Waist Circumference

Objective: To understand the association between central obesity, assessed by waist circumference, and the risks for ischemic heart disease (IHD), major coronary event (MCE), and IHD death. Methods: After excluding participants with heart disease, stroke, cancer, COPD, and diabetes at baseline survey, we included a total of 428 595 participants from the China Kadoorie Biobank for the analysis. The baseline survey was conducted from June 2004 to July 2008. We used Cox proportional hazards model to estimate the hazard ratio (HR) and 95%CI. Results: During an average 9.1 years of follow-up (3 803 637 person-years), we documented 26 900 incident cases of IHD, 4 320 cases of MCE, and 2 787 of deaths from IHD. After adjustment for possible confounders and BMI, central obesity was found to be associated with increased risks for IHD, MCE, and IHD death. The adjusted HRs (for the participants who had waist circumference of 85.0-89.9 cm in men and 80.0-84.9 cm in women were 1.13 (95%CI: 1.09-1.17) for IHD, 1.15 (95%CI: 1.05-1.26) for MCE and 1.11 (95%CI: 0.98-1.24) for IHD death. The respective HRs for those central obese participants (men ≥90.0 cm, women ≥85.0 cm) were 1.29 (95%CI: 1.24-1.34), 1.30 (95%CI: 1.17-1.44) and 1.32 (95%CI: 1.16-1.51). Further stratification analysis according to BMI showed that the risks for incident IHD, MCE, and IHD death increased along with the increase of waist circumference even in the participants with normal weight. Conclusion: This large-scale prospective study revealed that central obesity was an independent risk factor for IHD in adults in China, and the risk of IHD would increase with the increase of waist circumference.
Adult ; Asian People/statistics & numerical data* ; Body Mass Index ; China/epidemiology* ; Female ; Heart Diseases/ethnology* ; Humans ; Male ; Obesity ; Obesity, Abdominal/epidemiology* ; Overweight/epidemiology* ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Waist Circumference

PURPOSE: This study determined which obesity measurement correlates the best with diabetes and prediabetes. MATERIALS AND METHODS: This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines. RESULTS: After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity. CONCLUSION: Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.
Absorptiometry, Photon ; *Adiposity ; Adult ; Anthropometry ; Asian Continental Ancestry Group/*statistics & numerical data ; Biomarkers/blood ; Body Mass Index ; Cross-Sectional Studies ; Diabetes Mellitus/*ethnology ; Female ; Humans ; *Intra-Abdominal Fat ; Male ; Middle Aged ; Obesity/complications/*ethnology ; Odds Ratio ; Prediabetic State/*ethnology ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Waist Circumference

INTRODUCTIONMetabolic Syndrome (MetS) is associated with cardiovascular morbidity and mortality. Studies proposed that waist circumference (WC) and body mass index (BMI) are good indicators of MetS. In this study, we examined and compared the predictive utility of clinical measures such as WC, blood pressure and BMI and determined the cutoff points in which these measures are most reliable in identifying MetS in Singaporean Chinese.

MATERIALS AND METHODSTwo hundred and forty-four subjects aged between 21 and 50 years of Chinese ethnicity were recruited into the study. Sociodemographic, height, weight and blood pressure information were obtained. High-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and glucose levels were evaluated. Presence of MetS was examined according to American Heart Association (AHA)/National Heart, Lung and Blood Institute (NHLBI) guidelines. Predictive utility of BP, WC and BMI was examined using receiver operating curve and discriminant indices were determined accordingly.

RESULTSForty-one (16.8%) subjects were identified to have MetS. Our analysis revealed that waist circumference was most accurate in identifying MetS (area under the curve (AUC) = 0.88, 95% confidence interval (CI), 0.83 to 0.93, P <0.001) followed by BMI (AUC = 0.84, 95% CI, 0.77 to 0.91, P = 0.035), systolic BP (AUC = 0.83, 95% CI, 0.76 to 0.90, P = 0.036) and diastolic BP (AUC = 0.80, 95% CI, 0.71 to 0.88, P = 0.042). Waist circumference cut-off values of >92.5 cm in males and >86.5 cm in females were found to be most sensitive and specific in discriminating MetS.

CONCLUSIONOur finding has immediate and significant clinical implications as WC can be easily obtained. However, as the study included only Singaporean Chinese, findings cannot be generalised for other ethnic groups.

Adult ; Area Under Curve ; Blood Glucose ; analysis ; Blood Pressure ; physiology ; Body Height ; physiology ; Body Mass Index ; Body Weight ; physiology ; China ; ethnology ; Cholesterol, HDL ; blood ; Forecasting ; Health Status Indicators ; Humans ; Metabolic Syndrome ; diagnosis ; Middle Aged ; ROC Curve ; Sensitivity and Specificity ; Singapore ; Triglycerides ; blood ; Waist Circumference ; physiology ; Young Adult