RESEARCH PAPER Waist circumference in determining obesity and hypertension among 18–60 years old Bengalee Hindu male slum dwellers in Eastern India Raja Chakraborty 1 , Kaushik Bose 2 & Slawomir Koziel 3 1 Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon, West Bengal, India, 2 Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India, and 3 Institute of Anthropology, Polish Academy of Sciences, Wroclaw, Kuz ´nicza, Poland Background: Waist circumference (WC) has been previously shown to be the most efficient measure to explain variability in body mass index (BMI) and percentage body fat (PBF) in Bengalee males, including those under study. Aim: The objective was to evaluate the relative usefulness of WC and its single suitable value, if any, to identify both generalized obesity and hypertension in Bengalee men. Subjects and methods: This cross-sectional study included 433 adult (18 – 60 years) Bengalee Hindu slum dwelling men. Height, weight, waist circumference, systolic (SBP) and diastolic (DBP) blood pressures were measured. BMI was computed as weight (in kg) divided by height (in metres) squared. Hypertension (HT) was defined as SBP $ 140 mmHg and/or DBP $ 90 mmHg. A BMI $ 23 kg/m 2 and $ 25 kg/m 2 were considered overweight and obesity, respectively. Receiver operating characteristic (ROC) curve analyses were employed to determine the best cut-off points to define HT and overweight. Results: Prevalence of HT, overweight and obesity were 17.6% and 20.1% and 8.3%, respectively. Prevalence of central obesity using the cut-offs of 102 cm, 90 cm and 80 cm were 0.46%, 5.08% and 24.7%, respectively. Both in obese and non-obese, WC $ 80 cm was significantly associated with higher SBP and DBP than WC , 80 cm. WC . 79.4 cm and . 80.3 cm were the most appropriate for detecting HT and overweight status. Conclusion: WC value of , 80 cm could efficiently discriminate both obesity and hypertension among the Bengalee Hindu slum dwelling men aged between 18–60 years. Central obesity, determined by WC $ 80 cm, was associated with increased blood pressure and higher risk of HT, independent of age and general obesity. Keywords: Central obesity, waist circumference, BMI, hypertension, Bengalee, male, slum, ROC curve INTRODUCTION Central obesity is defined by an excess amount of fat in the abdominal region. It is an established risk factor for metabolic syndrome (MS) (Wang et al. 2005; Lear et al. 2010), cardiovascular disease (CVD) (Fujimoto et al. 1999; Nicklas et al. 2004) and other cardiovascular risk factors, e.g. hypertension (HT) (Lemieux et al. 2001; Johnson et al. 2002; Grievink et al. 2004). Waist circumference (WC) is a convenient proxy measure of central obesity and has been suggested to be the best anthropometric indicator of both total body fat and intra-abdominal fat mass (Seidell et al. 1997; Li et al. 2008). The International Diabetes Association (IDF) has recently recommended WC as a mandatory measure in its candidate definition of MS. It has recommended a single cut-off point for each component, except for WC, for identification of MS. Use of region- specific cut-offs of WC was recommended until a universal agreement is achieved (Alberti et al. 2009). Regional studies among local ethnic groups are, therefore, needed to find out appropriate cut-offs. Asian Indians have more total (Deurenberg-Yap et al. 2000) and abdominal fat (WHO 2000) compared to Europeans with a similar level of BMI. Several cut-off values of WC were proposed for identification of obesity, MS and its different components. The most accepted and widely used international cut-off point was 102 cm for males, corresponding to BMI $ 30 kg/m 2 in Europeans (Lean et al. 1998). However, several recent studies demonstrated that those cut-off values might not be appropriate for Asians (Zhou et al. 2005; Lee et al. 2007; Wang et al. 2009; Ogawa et al. 2010). In view of the Asian-Indian phenotype of higher body fat at lower BMI levels, the IDF has recommended an interim cut-off point of 90 cm for Asian men, while emphasizing upon further studies to find out regional cut-off points (Alberti et al. 2009). Correspondence: Dr Kaushik Bose, Associate Professor, Department of Anthropology, Vidyasagar University, Midnapore 721 102, West Bengal, India. E-mail banda@vsnl.net or kaushikbose@cantab.net. (Received 3 January 2011; accepted 6 July 2011 ) Annals of Human Biology, November – December 2011; 38(6): 669–675 Copyright q Informa UK, Ltd. ISSN 0301-4460 print/ISSN 1464-5033 online DOI: 10.3109/03014460.2011.605396 669 Ann Hum Biol Downloaded from informahealthcare.com by Mr Joris Roulleau on 11/11/11 For personal use only.