Supplementary material from: Chinese adults are more susceptible to effects of overall obesity and fat distribution on cardiometabolic risk factors

Context: The body mass index (BMI) and waist circumference (WC) as
diagnostic tools of obesity do not reflect the same level of fat mass and
whether obesity leads to various effects on cardiometabolic risk factors
among different racial/ethnic population is unknown. Objective: The study
aims to address the multicollinearity between BMI and WC by using the
residual model approach, and to assess and compare the effects of obesity
metrics on cardiometabolic risk factors among different races/ethnicities.
Design, setting and participants: Data from a nationally representative
sample of Mainland Chinese adults collected in 2010, and data from the
National Health and Nutrition Evaluation Survey (NHANES) 2005-2016 were
used. By conducting a regression analysis between WC and BMI, the
variation of BMI was removed from WC measures and residual of WC was
obtained. The associations between obesity metrics and cardiometabolic
risk factors were compared among different races/ethnicities by sex.
Results: The residual WC was significantly associated with all the
cardiometabolic risk factors in Mainland Chinese, and most of the factors
in Non-Hispanic White and Non-Hispanic Black adults, but not in the other
races/ethnicities. The standardized regression coefficients of the
associations between obesity metrics and cardiometabolic factors showed
that the obesity metrics had greater impact on systolic blood pressure,
diastolic blood pressure and triglyceride in Chinese adults than those of
other racial/ethnic groups. Conclusions: Chinese adults are more
susceptible to the effects of overall obesity and fat distribution on
cardiometabolic risk factors than the other racial/ethnic population.