Redefining Obesity in the Indonesian Population: The Critical Role of Waist-to-Height Ratio in Screening for Diabetes Mellitus and Hypertension.

IF 2.4 Q3 NUTRITION & DIETETICS
Journal of Nutrition and Metabolism Pub Date : 2025-09-02 eCollection Date: 2025-01-01 DOI:10.1155/jnme/5815261
Ratu Ayu Dewi Sartika, Fathimah Sulistyowati Sigit, Nurul Husna Mohd Shukri, Edy Purwanto, Jasrida Yunita, Pika Novriani Lubis
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Abstract

Objectives: Waist-to-height ratio (WHtR) is an alternative index to evaluate metabolic health and predict the risk of estimating the impact of adiposity on cardiometabolic diseases. Despite the significance, the diagnostic performance of WHtR has not been extensively investigated in large epidemiological studies in Indonesia. Therefore, this study aimed to investigate anthropometric indexes (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], and WHtR) with the best clinically accurate and diagnostic performance in detecting the prevalence of diabetes mellitus (DM) and hypertension (HTN) in the Indonesian population. Methods: This study used a cross-sectional method to analyze big data of 7699 individuals from the Indonesian Family Life Survey. The diagnostic performance of each anthropometric index was analyzed using the receiver operating characteristics (ROC) curve model in the SPSS and MedCalc applications. Furthermore, the associations of anthropometric indexes with DM and HTN were evaluated using logistic regression adjusted for sociodemographic confounders. Results: WHtR showed the highest area under the curve (AUC) for detecting DM in men (0.731 [0.679-0.784]), as well as HTN in both men (0.650 [0.629-0.671]) and women (0.615 [0.598-0.633]). Although often negligible, the discrepancies had overlapping 95% confidence intervals with other indexes. WHtR also showed the strongest association with both DM (AOR [95% CI]: 3.166 [2.416-4.150]) and HTN (1.938 [1.703-2.206]). Lower cutoffs for BMI (22.72 kg/m2) and WC (83.35 cm) enhanced sensitivity for DM and HTN detection, particularly in men. Discussion: WHtR outperformed BMI, WC, and WHR in detecting DM and HTN in the Indonesian population. Additionally, lower cutoffs for overall (BMI) and abdominal obesity (WC) should be considered to enhance the sensitivity of anthropometric indexes in screening for cardiometabolic diseases in the population.

Abstract Image

印尼人口肥胖的重新定义:腰高比在糖尿病和高血压筛查中的关键作用。
目的:腰高比(WHtR)是评估代谢健康和预测肥胖对心脏代谢疾病影响风险的替代指标。尽管具有重要意义,但在印度尼西亚的大型流行病学研究中尚未对WHtR的诊断性能进行广泛调查。因此,本研究旨在探讨印尼人群中最具临床准确性和诊断价值的人体测量指标(体重指数[BMI]、腰围[WC]、腰臀比[WHR]和WHtR)。方法:本研究采用横断面法对印度尼西亚家庭生活调查7699人的大数据进行分析。采用SPSS和MedCalc应用程序中的受试者工作特征(ROC)曲线模型分析各人体测量指标的诊断性能。此外,使用经社会人口学混杂因素调整的逻辑回归评估了人体测量指标与DM和HTN的关联。结果:男性WHtR曲线下面积(AUC)最高(0.731[0.679-0.784]),男性HTN最高(0.650[0.629-0.671]),女性最高(0.615[0.598-0.633])。虽然通常可以忽略不计,但差异与其他指数的95%置信区间重叠。WHtR与DM (AOR [95% CI]: 3.166[2.416-4.150])和HTN(1.938[1.703-2.206])的相关性最强。BMI (22.72 kg/m2)和WC (83.35 cm)较低的临界值增强了DM和HTN检测的敏感性,尤其是在男性中。讨论:在印度尼西亚人群中,WHtR在检测糖尿病和HTN方面优于BMI、WC和WHR。此外,应考虑降低总体(BMI)和腹部肥胖(WC)的临界值,以提高人体测量指标在人群中筛查心脏代谢疾病的敏感性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Nutrition and Metabolism
Journal of Nutrition and Metabolism NUTRITION & DIETETICS-
CiteScore
5.40
自引率
0.00%
发文量
49
审稿时长
17 weeks
期刊介绍: Journal of Nutrition and Metabolism is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies covering the broad and multidisciplinary field of human nutrition and metabolism. The journal welcomes submissions on studies related to obesity, diabetes, metabolic syndrome, molecular and cellular biology of nutrients, foods and dietary supplements, as well as macro- and micronutrients including vitamins and minerals.
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