Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African-Americans

• Published in: Diabetes care Vol. 21; no. 11; pp. 1836 - 1842
• Main Authors: Okosun, I.S, Cooper, R.S, Rotimi, C.N, Osotimehin, B, Forrester, T
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-11-1998
• Subjects: Abdomen; Adult; African Americans - statistics & numerical data; African Continental Ancestry Group; Aged; Analysis. Health state; anthropometric measurements; Biological and medical sciences; Blacks; Blood Glucose - analysis; Blood pressure; Body Composition - physiology; Body fat; body measurements; Cardiovascular Diseases - complications; Cardiovascular Diseases - ethnology; Collaboration; Cross-Sectional Studies; Diabetes; diabetes mellitus; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - ethnology; Diaspora; Epidemiology; Female; General aspects; girth; Glucose; Humans; Hypertension; Hypertension - epidemiology; Hypertension - ethnology; Jamaica - epidemiology; Male; Measurement techniques; Medical sciences; men; Middle Aged; Nigeria - epidemiology; Nutrition; Pharmacists; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression analysis; Research design; Risk Factors; Sex Factors; surveys; United States - epidemiology; Variables; waist measurements; women; Womens health; Nigeria; Jamaica; United States; Central America; Africa; America; West Indies; North America; United States > US; Endocrinopathy; Human; Hypertension; Countries; Anthropometry; Sex; Negroid; Cardiovascular disease; Non insulin dependent diabetes; Epidemiology; Risk factor; Adult; Arterial pressure; Elderly; Comparative study; Glycemia
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.21.11.1836

Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African-Americans.
I S Okosun ,
R S Cooper ,
C N Rotimi ,
B Osotimehin and
T Forrester
Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, Illinois 60153,
USA. [e-mail]
Abstract
OBJECTIVE: Prior studies have supported that waist circumference correlates better with visceral adipose tissue and is a better
predictor of cardiovascular disease than are BMI and waist-to-hip ratio. In this study, we reexamine the role of waist size
on the risk of hypertension and type 2 diabetes in African-origin populations from three contrasting environments. RESEARCH
DESIGN AND METHODS: A cross-sectional survey was conducted of 5,042 men and women 25-74 years of age from Nigeria, Jamaica,
and the U.S. The relationship between waist, blood pressure, and fasting blood glucose was assessed using multiple linear
regression analyses. Logistic regression analyses using sex-specific empirical waist cut-points were used to determine the
risks of hypertension and type 2 diabetes. RESULTS: Waist circumference was positively correlated with blood pressure and
fasting blood glucose (P < 0.05). Increasing waist quartiles were significantly associated with higher risks of hypertension
in the three populations, as estimated from age-adjusted odds ratios obtained from sex-specific logistic regression models.
A highly elevated risk of type 2 diabetes-10-fold for Jamaican men and 23-fold for African-American women-was observed in
the comparison of lowest to highest quartiles of waist circumference. CONCLUSIONS: Substantial reduction in hypertension and
diabetes in men and women is achievable if the waist size is decreased in these populations. Intervention programs designed
to reduce waist circumference through lifestyle modification, including exercise and diet, may have significant public health
significance in reducing the incidence of hypertension and adult-onset diabetes in these populations.