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Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study

In this study we evaluated and redefined the optimum body mass index (BMI) cut-off point for the Iranian population based on metabolic syndrome (MeS) risk factors. We further evaluated BMI cut-off points with and without waist circumference (WC) as a cofactor of risk and compared the differences. Th...

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Autores principales: Babai, Mohammad Ali, Arasteh, Peyman, Hadibarhaghtalab, Maryam, Naghizadeh, Mohammad Mehdi, Salehi, Alireza, Askari, Alireza, Homayounfar, Reza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980035/
https://www.ncbi.nlm.nih.gov/pubmed/27509026
http://dx.doi.org/10.1371/journal.pone.0160639
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author Babai, Mohammad Ali
Arasteh, Peyman
Hadibarhaghtalab, Maryam
Naghizadeh, Mohammad Mehdi
Salehi, Alireza
Askari, Alireza
Homayounfar, Reza
author_facet Babai, Mohammad Ali
Arasteh, Peyman
Hadibarhaghtalab, Maryam
Naghizadeh, Mohammad Mehdi
Salehi, Alireza
Askari, Alireza
Homayounfar, Reza
author_sort Babai, Mohammad Ali
collection PubMed
description In this study we evaluated and redefined the optimum body mass index (BMI) cut-off point for the Iranian population based on metabolic syndrome (MeS) risk factors. We further evaluated BMI cut-off points with and without waist circumference (WC) as a cofactor of risk and compared the differences. This study is part of the largest surveillance programs conducted in Shiraz, Iran, termed the Shiraz Heart study. Our study sample included subjects between the ages of 20 to 65 years old. After excluding pregnant women, those with missing data and those with comorbid disease, a total of 12283 made up the study population. The participants underwent a series of tests and evaluations by trained professionals in accordance with WHO recommendations. Hypertension, abnormal fasting blood sugar (FBS), triglyceride (TG) and high density lipoprotein cholesterol (HDL) (in the context of the definition of metabolic syndrome) were prevalent among 32.4%, 27.6%, 42.1 and 44.2% of our participants, respectively. Women displayed higher rates of overall obesity compared to men (based on the definition by the WHO as higher than 30 kg/m(2)). Regarding MeS, 38.9% of our population had the all symptoms of MeS which was more prevalent among women (41.5% vs. 36%). When excluding WC in the definition of MeS, results showed that males tend to show a higher rate of metabolic risk factors (19.2% vs. 15.6%). Results of multivariate analysis showed that parallel to an increase in BMI, the odds ratio (OR) for acquiring each component of the metabolic syndrome increased (OR = 1.178; CI: 1.166–1.190). By excluding WC, the previous OR decreased (OR = 1.105; CI: 1.093–1.118). Receiver Operating Characteristic (ROC) curve analysis showed that the optimum BMI cut-off point for predicting metabolic syndrome was 26.1 kg/m(2) and 26.2 kg/m(2) [Accuracy (Acc) = 69% and 61%, respectively)] for males and females, respectively. The overall BMI cut-off for both sexes was 26.2 kg/m(2) (Acc = 65%) with sensitivity and specificity of 69% and 62%, respectively. This cut-off had a positive predictive value of 54% and a negative predictive value of 76%. When we excluded waist circumference, the optimum BMI cut-off for acquiring metabolic risk factors in males decreased to 25.7 kg/m(2) (Acc = 67%) and increased for women to 27.05 kg/m(2) (Acc = 66%). Iranians are at higher risks of morbidity related to metabolic factors at a lower BMI cut-off and prompt action and preventive health policy are required to prevent and educate Iranians regarding diseases associated with obesity.
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spelling pubmed-49800352016-08-25 Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study Babai, Mohammad Ali Arasteh, Peyman Hadibarhaghtalab, Maryam Naghizadeh, Mohammad Mehdi Salehi, Alireza Askari, Alireza Homayounfar, Reza PLoS One Research Article In this study we evaluated and redefined the optimum body mass index (BMI) cut-off point for the Iranian population based on metabolic syndrome (MeS) risk factors. We further evaluated BMI cut-off points with and without waist circumference (WC) as a cofactor of risk and compared the differences. This study is part of the largest surveillance programs conducted in Shiraz, Iran, termed the Shiraz Heart study. Our study sample included subjects between the ages of 20 to 65 years old. After excluding pregnant women, those with missing data and those with comorbid disease, a total of 12283 made up the study population. The participants underwent a series of tests and evaluations by trained professionals in accordance with WHO recommendations. Hypertension, abnormal fasting blood sugar (FBS), triglyceride (TG) and high density lipoprotein cholesterol (HDL) (in the context of the definition of metabolic syndrome) were prevalent among 32.4%, 27.6%, 42.1 and 44.2% of our participants, respectively. Women displayed higher rates of overall obesity compared to men (based on the definition by the WHO as higher than 30 kg/m(2)). Regarding MeS, 38.9% of our population had the all symptoms of MeS which was more prevalent among women (41.5% vs. 36%). When excluding WC in the definition of MeS, results showed that males tend to show a higher rate of metabolic risk factors (19.2% vs. 15.6%). Results of multivariate analysis showed that parallel to an increase in BMI, the odds ratio (OR) for acquiring each component of the metabolic syndrome increased (OR = 1.178; CI: 1.166–1.190). By excluding WC, the previous OR decreased (OR = 1.105; CI: 1.093–1.118). Receiver Operating Characteristic (ROC) curve analysis showed that the optimum BMI cut-off point for predicting metabolic syndrome was 26.1 kg/m(2) and 26.2 kg/m(2) [Accuracy (Acc) = 69% and 61%, respectively)] for males and females, respectively. The overall BMI cut-off for both sexes was 26.2 kg/m(2) (Acc = 65%) with sensitivity and specificity of 69% and 62%, respectively. This cut-off had a positive predictive value of 54% and a negative predictive value of 76%. When we excluded waist circumference, the optimum BMI cut-off for acquiring metabolic risk factors in males decreased to 25.7 kg/m(2) (Acc = 67%) and increased for women to 27.05 kg/m(2) (Acc = 66%). Iranians are at higher risks of morbidity related to metabolic factors at a lower BMI cut-off and prompt action and preventive health policy are required to prevent and educate Iranians regarding diseases associated with obesity. Public Library of Science 2016-08-10 /pmc/articles/PMC4980035/ /pubmed/27509026 http://dx.doi.org/10.1371/journal.pone.0160639 Text en © 2016 Babai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Babai, Mohammad Ali
Arasteh, Peyman
Hadibarhaghtalab, Maryam
Naghizadeh, Mohammad Mehdi
Salehi, Alireza
Askari, Alireza
Homayounfar, Reza
Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study
title Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study
title_full Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study
title_fullStr Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study
title_full_unstemmed Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study
title_short Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study
title_sort defining a bmi cut-off point for the iranian population: the shiraz heart study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980035/
https://www.ncbi.nlm.nih.gov/pubmed/27509026
http://dx.doi.org/10.1371/journal.pone.0160639
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