Anthropometric indicators of adiposity as predictors of systemic arterial hypertension in older people: a cross-sectional analysis

Santos, Lucas dos; Pedreira, Rhaine Borges Santos; Silva, Rizia Rocha; Barbosa, Raquel dos Santos; Valença Neto, Paulo da Fonseca; Casotti, Cezar Augusto

doi:10.1590/1678-9865202336e220137

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Original - Collective Health • Rev. Nutr. 36 • 2023 • https://doi.org/10.1590/1678-9865202336e220137 copy

Anthropometric indicators of adiposity as predictors of systemic arterial hypertension in older people: a cross-sectional analysis

Indicadores antropométricos de adiposidade como preditores de hipertensão arterial sistêmica em pessoas idosas: uma análise transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the association of anthropometric indicators of adiposity in older people, according to sex, with hypertension; to compare the scores of these variables between participants with and without hypertension; and to identify among them those with better predictive ability for screening the outcome.

Methods:

Epidemiological, population-based, cross-sectional study conducted with 210 older people. The anthropometric indicators analyzed were: body mass index, waist circumference, abdominal circumference, body adiposity index, triceps skinfold, waist-to-hip ratio, waist-to-height ratio, and conicity index. Hypertension diagnosis was self-reported.

Results:

The indicators of adiposity increased the probability of hypertension. Additionally, hypertensive older people of both sexes showed higher scores on adiposity indicators than non-hypertensive subjects (p < 0.05). For men, the most sensitive indicator for the outcome was conicity index (81.82%; cut-off point: 1.30) and the most specific was body mass index (69.77%; cut-off point: 25.05 kg/m²). For women, the most sensitive indicator for the outcome was the body adiposity index (86.08%; cut-off point: 31.03%), and the most specific was the abdominal circumference (82.82%; cut-off point: 98.70 cm).

Conclusion:

In both sexes, the indicators of adiposity were positively associated with hypertension; hypertensive participants showed higher values in the scores of the indicators. Additionally, the body adiposity index (women) and conicity index (men) demonstrated greater ability to screen for hypertension, while the abdominal circumference and body mass index demonstrated greater ability to screen for non-hypertensive women and men, respectively.

Keywords:
Adipose tissue; Aging; Blood pressure; Epidemiology

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[1] Correspondence to: L SANTOS. E-mail: <lsantos.ed.f@gmail.com>.

Variables		% response	n	%
Sex		100.00
	Male		87	41.40
	Female		123	58.60
Age Group		100.00
	60-79 years		87	41.40
	70-79 years		88	41.90
	≥80 years		35	16.70
Skin color/ Race		96.66
	White		31	15.30
	Not White		172	84.70
Marital status		100.00
	With partner		115	54.80
	Without partner		95	45.20
Education		98.09
	With schooling		80	38.80
	Without schooling		126	61.20
Income*		93.80
	≤1 minimum wage		170	86.30
	>1 minimum wage		27	13.70
Smoking		100.00
	No		190	90.50
	Yes		20	9.50
Alcohol consumption		100.00
	No		164	78.10
	Yes		46	21.90
Level of physical activity		100.00
	Sufficient		101	48.10
	Insufficient		109	51.90
High sedentary behavior		100.00
	No		152	72,38
	Yes		58	27,62
Diabetes Mellitus		100.00
	No		173	82.40
	Yes		37	17.60

Variables	Men								p-value
	Non-Hypertensive (n = 43)				Hypertensive (n = 44)
	M	SD	Mdn	IQR	M	SD	Mdn	IQR
Body mass index (kg/m²)	23.52	3.68			25.74	3.01			0.003^*
Waist circumference (cm)	87.35	10.37			95.74	8.72			<0.001^*
Abdominal circumference (cm)			89.80	17.80			96.35	10.50	0.001^**
Body adiposity index (%)	26.50	3.57			28.01	3.25			0.009^*
Triceps skin fold (mm)	14.88	4.82			18.14	4.87			0.002^*
Waist-to-hip ratio	0.95	0.06			0.98	0.05			0.001^*
Waist-to-height ratio	0.53	0.06			0.58	0.05			<0.001^*
Conicity index			1.29	0.08			1.36	0.09	<0.001^**
Variables	Women								p-value
	Non-Hypertensive (n = 44)				Hypertensive (n = 79)
	M	SD	Mdn	IQR	M	SD	Mdn	IQR
Body mass index (kg/m²)	23.97	4.68			27.79	5.42			<0.001^*
Waist circumference (cm)	86.51	14.43			95.89	13.44			<0.001^*
Abdominal circumference (cm)			91.33	13.10			100.00	12.71	<0.001^**
Body adiposity index (%)	31.82	9.50			37.18	6.60			<0.001^*
Triceps skin fold (mm)	26.61	8.90			26.27	8.73			0.834^*
Waist-to-hip ratio			0.92	0.10			0.95	0.10	0.151^**
Waist-to-height ratio	0.57	0.10			0.63	0.09			0.001^*
Conicity index			1.33	0.14			1.38	0.13	0.013^**

Variables	Men		p-value
Variables	Adjusted PR	95% CI	p-value
Body mass index (kg/m²)^a	1.09	1.03-1.15	0.003
Waist circumference (cm)^a	1.04	1.02-1.06	<0.001
Abdominal circumference (cm)^b	1.04	1.02-1.07	<0.001
Body adiposity index (%)^c	1.08	1.02-1.14	0.010
Triceps skin fold (mm)^c	1.05	1.02-1.09	0.002
Waist-to-hip ratio^a	1.05	1.02-1.08	0.002
Waist-to-height ratio^c	1.06	1.02-1.09	0.001
Conicity index^c	1.02	1.01-1.03	<0.001
Variables	Women		p-value
Variables	Adjusted PR	95% CI	p-value
Body mass index (kg/m^2)d	1.05	1.02-1.07	<0.001
Waist circumference (cm)^e	1.02	1.01-1.03	0.002
Abdominal circumference (cm)^e	1.02	1.01-1.03	0.001
Body adiposity index (%)^f	1.03	1.01-1.05	<0.001
Triceps skin fold (mm)^g	1.01	0.97-1.04	0.402
Waist-to-hip ratio^h	1.01	0.98-1.02	0.502
Waist-to-height ratioⁱ	1.02	1.01-1.03	0.003
Conicity indexⁱ	1.02	1.01-1.03	0.002

Variables	Men
Variables	Cut-off point	Sensitivity (95% CI)	Specificity (95% CI)	PPV (95% CI)	NPV (95% CI)	AUC (95% CI)
BMI (kg/m²)	25.05	61.36 (45.50-75.60)	69.77 (53.90-82.80)	65.50 (55.50-77.50)	63.80 (53.70-72.90)	0.68 (0.57-0.77)
WC (cm)	91.90	75.00 (59.70-86.80)	67.44 (51.50-80.90)	70.02 (59.70-78.90)	72.50 (60.30-82.10)	0.72 (0.62-0.81)
AC (cm)	90.30	79.55 (64.70-90.20)	55.81 (39.90-70.90)	64.80 (56.00-72.70)	72.70 (58.40-83.50)	0.71 (0.60-0.80)
BAI (%)	26.56	70.45 (54.80-83.20)	62.79 (46.70-77.00)	66.0 (55.70-74,90)	67.50 (55.50-77.60)	0.66 (0.55-0.75)
TSF (mm)	16.00	70.45 (54.80-83.20)	62.79 (46.70-77.00)	66.00 (55.70-74.90)	67.50 (55.50-77.60)	0.69 (0.58-0.78)
WHR	0.90	81.82 (67.30-91.80)	48.84 (33.30-64.50)	62.10 (54.20-69.30)	72.40 (56.70-84.10)	0.66 (0.55-0.74)
WHtR	0.50	72.73 (57.20-85.00)	55.81 (39.90-70.90)	62.70 (53.50-71.20)	66.70 (53.50-77.60)	0.67 (0.56-0.74)
CIn	1.30	81.82 (67.30-91.80)	55.81 (39.90-70.90)	70.80 (60.50-79.40)	74.40 (61.80-83.90)	0.75 (0.65-0.84)
Variables	Women
Variables	Cut-off point	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	AUC (95%CI)
BMI (kg/m²)	24.89	70.89 (59.60-80.60)	59.09 (43.20-73.70)	75.70 (68.00-82.00)	53.10 (42.50-63.30)	0.68 (0.61-0.77)
WC (cm)	94.60	59.49 (47.90-70,40)	79.55 (64.70-90.20)	83.90 (73.90.90.60)	52.20 (44.60-59.80)	0.69 (0.61-0.77)
AC (cm)	98.70	55.70 (44.10-66.90)	81.82 (67.30-91.80)	(84.60) (74.00-91.40)	50.70 (43.60-57.70)	0.68 (0.60-0.77)
BAI (%)	31.03	86.08 (76.50-92.80)	50.00 (34.60-65.40)	75.30 (68.40-81.20)	57.10 (45.00-68.50)	0.69 (0.60-0.77)
WHtR	0.60	48.10 (45,30-68,10)	79.55 (62.20-88.50)	80.90 (69.30-88.80)	46.10 (39.70-52.50)	0.67 (0.58-0.75)
CIn	1.37	56.96 (45.30-68.10)	77.27 (62.20-88,50)	81.80 (71.6.88.90)	50.00 (42.60-57.40)	0.64 (0.55-0.72)