“A body shape index” and its association with arterial hypertension and diabetes mellitus among Brazilian older adults: National Health Survey (2013)

The aim was to evaluate the separate and joint association of abdominal adiposity indicators (a body shape index - ABSI, waist circumference - WC, waist-to-height ratio - WHtR) and body mass index (BMI) with arterial hypertension and diabetes mellitus, in Brazilian older adults. Data from the 2013 Brazilian National Health Survey (PNS 2013) were used for the population aged 60 years or older (10,537 older adults). Arterial hypertension and diabetes mellitus outcomes were self-reported and the following anthropometric indices were evaluated by direct measurement: a ABSI, BMI, WC and WHtR. Associations were assessed by logistic regression, with adjustments for confounding factors. The results of this study evidenced a higher strength of association between the report of arterial hypertension and diabetes mellitus with BMI, WC and WHtR in the Brazilian population of older adults in separate analyses, when compared to ABSI. When adjusted for BMI, ABSI showed a greater strength of association with the outcomes, but it was not superior to the performance of WC and WHtR. Considering the lower strength of association, in separate and joint analyses, between the new index (ABSI) and the chronic conditions assessed, BMI, WC and WHtR probably remain as useful indices in public health, at least in relation to arterial hypertension and diabetes mellitus in Brazilian older adults.

本研究旨在评估巴西老年人群中，腹部肥胖相关指标[体形状指数（Body Shape Index，ABSI）、腰围（Waist Circumference，WC）、腰围身高比（Waist-to-Height Ratio，WHtR）]与体重指数（Body Mass Index，BMI）分别及联合与动脉高血压、糖尿病的关联。本研究使用2013年巴西全国健康调查（PNS 2013）中60岁及以上老年人群的数据，共纳入10537名老年人。其中，动脉高血压与糖尿病的患病信息通过自我报告获得，体形状指数、体重指数、腰围及腰围身高比四项人体测量学指标均通过直接测量获取。本研究采用logistic回归分析评估各指标与结局的关联，并对混杂因素进行校正。结果显示，在独立分析中，与ABSI相比，BMI、WC及WHtR与巴西老年人群动脉高血压、糖尿病自我报告患病情况的关联强度更高。在校正BMI后，ABSI与上述两种慢性病结局的关联强度有所提升，但仍未优于WC及WHtR的表现。鉴于在独立与联合分析中，新型指标ABSI与本次评估的慢性病（动脉高血压与糖尿病）的关联强度均较低，因此BMI、WC及WHtR或许仍可作为公共卫生领域的实用指标，至少在巴西老年人群的动脉高血压与糖尿病相关研究中适用。