CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 8, September 2012
444
AFRICA
Alemedia recommended a cut-off point of 86 cm for WC, 0.87
for WHR and 1.25 for CI as indicators of increased occurrence
of cardiovascular risk factors, despite the lack of consensus
between studies.
14
Other studies gave 1.18 as the best cut-off
point for CI. Almeida reported that CI had the highest sensitivity
and specificity for predicting the occurrence of cardiovascular
risk factors.
14
In our study, the postmenopausal women had a
mean WC of 87.1
±
9
cm, WHR of 0.85
±
0.07
and CI of 1.24
±
0.9,
which verified the use of central obesity to indicate a high
probability of the occurrence of cardiovascular risk factors in
these participants.
Zhou
et al
.
reported that BMI, WC and CI had an association
with blood pressure but WC in men and BMI in women had the
highest association with blood pressure.
15
In our study, only BMI
had a significant association with SBP. In comparison to our
study, Zhou’s study was done on a larger population (29 179 vs
150
participants). Zhou indicated that visceral obesity, measured
by WC or WHR was more closely associated with blood
pressure and/or the presence of hypertension than overall obesity,
measured by BMI. Furthermore, the linear regression coefficient
for each obesity measurement with continuous SBP or DBP was
substantially greater in men than in women, suggesting a greater
male responsiveness of blood pressure to a gain than weight or
abdominal deposition.
15
Dalton reported a higher association of BMI with blood
pressure and LDL-C and HDL-C levels compared to WC.
However, he had more participants compared to our study
(11 247
vs 150 persons) and he did not make use of conicity
index.
8
Neufeld reported the best cut-off points for pre-diabetes
status as 27.8 kg/m
2
for BMI, 89.8 cm for WC and 1.28 for
CI. In his study, BMI had more sensitivity and specificity with
pre-hydration and pre-diabetes compared to WC and CI, but
his study was carried out on under 35-year-old pre-menopausal
women.
16
The results of the studies by Ghosh, and Sanchez Viveros
et al.
in postmenopausal and elderly subjects, respectively, was
consistent with our study. They reported that CI had a higher
association with type 2 diabetes compared to BMI and WC.
17,18
On the other hand, Ghosh indicated a significant difference
between central obesity and fat-free mass among normotensive
and hypertensive subjects, although their level of obesity was
similar.
17
Hypertensive individuals had significantly enhanced
levels of central body fat distribution, which was consistent with
the findings of our study.
TABLE 2. CORRELATION MATRIXWITH PEARSON CORRELATION COEFFICIENT OF MEASUREDVARIABLES
BMI
WC WHR SBP DBP FBS
PIL
TC TG HDL-C LDL-C FM CI
BMI
–
0.67* 0.33* 0.21* 0.10 –0.06 –0.10 –0.11 –0.06
0.01 –0.04
0.31*
WC
–
–
–
0.26* 0.16* –0.15 –0.08 –0.06 –0.12 –0.07 –0.04
0.86*
WHR
–
–
–
0.29* 0.10 –0.15 –0.03 –0.00 –0.15 –0.03 0.03 –0.00 0.84*
SBP
–
–
–
–
–0.05 –0.22* 0.20* 0.00
0.13 0.16*
0.22*
DBP
–
–
–
–
0.01 –0.15 0.10
0.04
0.11 0.04
0.08
FBS
–
–
–
–
0.23* 0.41* 0.28* 0.30* 0.29*
–0.16*
PIL
–
–
–0.06 0.29* –0.09 –0.13
–0.07
TC
–
–
–
–
–
–
–
–
0.28* 0.15
0.84*
–0.06
TG
–
–
–
–
–
–
–
–
–
0.03 –0.06
–0.17*
LDL-C
–
–
–
–
–
–
–
–
–
–
–
–0.00
HDL-C
–
–
–
–
–
–
–
–
–
–
–
–0.07
FM
BMI: body mass index, WC: waist circumference, WHR: waist–hip ratio, SBP: systolic blood pressure, DBP: diastolic blood pressure, FBS: fasting blood
sugar, PIL: plasma insulin level, TC: total cholesterol, TG: triglycerides, LDL-C: low-density lipoprotein cholesterol, HDL-C: high-density lipoprotein
cholesterol, FM: fat mass. *
p
<
0.05.
TABLE 3. MEASUREDVARIABLES (MEANAND SD) OF STUDY SUBJECTSACCORDINGTO QUARTILES OF CI
Variables
CI
1
st Q
<
1.18
(
n
=
37)
2
nd Q 1.18
>
1.23
(
n
=
38)
3
rs Q 1.23
<
1.31
(
n
=
38)
4
th Q
≥
1.31
(
n
=
37)
Age*
55.37 (7.33)
55.76 (6.56)
56.29 (5.40)
60.18 (9.87)
Weight (kg)**
61.67 (7.56)
64.92 (8.82)
65.78 (7.03)
66.10 (8.24)
Height (cm)
157.62 (5.27)
157.26 (5.55)
156.72 (6.23)
156.02 (7.65)
SBP (mmHg)**
11.13 (1.31)
11.69 (1.70)
11.51 (1.36)
12.01 (1.37)
DBP (mmHg)
7.35 (1.06)
7.68 (0.98)
7.24 (0.98)
7.67 (0.74)
Waist (cm)*
77.29 (6.24)
84.39 (5.13)
89.75 (4.86)
97.43 (5.25)
FBS (mg/dl)
109.81 (69.33)
90.71 (24.57)
101.78 (42.76)
86.89 (11.99)
TC (mg/dl)
200.02 (49.44)
192.00 (45.57)
185.64 (43.53)
192.70 (41.93)
TG (mg/dl)
251.78 (135.79)
202.81 (87.87)
197.48 (98.54)
201.78 (80.97)
HDL-C (mg/dl)
40.45 (7.29)
38.63 (7.95)
37.27 (6.14)
39.00 (6.13)
LDL-C (mg/dl)
113.40 (43.12)
112.42 (45.90)
105.62 (37.53)
114.20 (41.25)
SBP: systolic blood pressure, DBP: diastolic blood pressure, FBS: fasting blood sugar, TC: total cholesterol, TG: triglycerides, LDL-C: low-density lipo-
protein cholesterol, HDL-C: high-density lipoprotein cholesterol. *
p
<
0.05, **
p
<
0.01.
