Defining abdominal obesity as a risk factor for coronary heart disease in the US: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Objective: Various organizations have highlighted the need to examine whether abdominal obesity cut-points are appropriate for identification of cardiovascular risk among ethnic minority adults, particularly Hispanic/Latino living in western societies. This study aimed (1) to establish optimal definitions for abdominal obesity among Hispanic/Latinos, and (2) determine the level of agreement between the presence of metabolic syndrome diagnosed by the current Joint Interim Statement (IJS) definition and an updated definition with optimal abdominal obesity cut points. Research Design and Methods: The sample included 16,289 adults who self-identified as Hispanic/Latino ages 18-74 years enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Receiving operating characteristic (ROC) curves were used to derive sensitivity and specificity values. The largest sum of sensitivity plus specificity was used to determine appropriate cut-points. Results: Among US Hispanic/Latino adults, waist circumference cut points of >102 cm in men (in line with current IJS criteria) and >97 cm (9 points higher than IJS criteria) in women provide optimal discrimination for cardiovascular risk as judged by the presence of coronary heart disease. When using these cut points to create an updated metabolic syndrome definition among women, we found disagreement between our updated definition and the current IJS criteria. The prevalence of the metabolic syndrome was overestimated by about 5% points among women based on IJS criteria when compared to our definition. Conclusions: Our results suggest that the current recommendations for waist circumference cut-points may not be appropriate for US Hispanic/Latino women.

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Defining Abdominal Obesity as a Risk Factor for Coronary Heart Disease in the U.S.: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Diabetes Care ◽

10.2337/dc19-1855 ◽

2020 ◽

Vol 43 (8) ◽

pp. 1774-1780

Author(s):

Diana A. Chirinos ◽

Maria M. Llabre ◽

Ronald Goldberg ◽

Marc Gellman ◽

Armando Mendez ◽

...

Keyword(s):

Coronary Heart Disease ◽

Risk Factor ◽

Heart Disease ◽

Community Health ◽

Abdominal Obesity ◽

Health Study ◽

Hispanic Community ◽

The U.S

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Abstract P246: Dietary Minerals and Metabolic Syndrome: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽

10.1161/circ.137.suppl_1.p246 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Catherine M Bulka ◽

Martha L Daviglus ◽

Daniela Sotres-Alvarez ◽

Ramon A Durazo-Arvizu ◽

Yasmin Mossavar-Rahmani ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Community Health ◽

High Blood Pressure ◽

Abdominal Obesity ◽

Fasting Glucose ◽

Health Study ◽

Hispanic Community ◽

Copper Manganese ◽

High Fasting Glucose

Introduction: Minerals play an integral role in lipid and carbohydrate metabolism and defense against oxidative damage, and thus mineral-poor diets may be an important risk factor for cardiometabolic disease. Little is known about the relationship between dietary mineral intake and metabolic health in Hispanics/Latinos - the largest ethnic minority in the U.S. Hypothesis: Individuals consuming less than recommended amounts of certain minerals may have a greater burden of metabolic syndrome, independent of individual-level risk factors. Methods: We studied 15,051 Hispanic/Latino individuals, aged 18-74 years, from the Hispanic Community Health Study/Study of Latinos, a population-based epidemiologic study of adults enrolled from 4 U.S. communities in 2008-2011. Daily intakes of selected minerals (copper, manganese, selenium, and zinc) from up to two dietary recalls were averaged, and combined with self-reported supplemental intakes. Copper, selenium, and zinc intake levels were dichotomized at the estimated average requirement (EAR); for manganese, the adequate intake (AI) was used as a cutoff point as an EAR has not been established. Metabolic syndrome and its component abnormalities were defined per the harmonized American Heart Association/National Heart, Lung, and Blood Institute criteria as at least 3 of the following 5 criteria: high blood pressure, high triglycerides, low HDL cholesterol, high fasting glucose, or abdominal obesity. Associations of mineral intakes with prevalent metabolic syndrome and its individual components were evaluated using logistic regression models accounting for the complex sampling design of the study. Results: Intakes of copper, manganese, selenium, and zinc were below the EAR/AI in 15%, 29%, 4%, and 13% of individuals, respectively. Copper intake below the EAR was positively associated with metabolic syndrome (OR: 1.23, 95% CI: 1.05-1.44) after adjustment for energy intake, age, gender, and Hispanic/Latino background, and was primarily driven by an association with high blood pressure (1.24, CI: 1.04-1.47). Manganese intake below the AI was also associated with metabolic syndrome (1.16, CI: 1.01-1.32), with the strongest associations observed for high fasting glucose levels (1.20, CI: 1.04-1.38) and abdominal obesity (1.19, CI: 1.05-1.36). Conclusion: Consuming less than the recommended amounts of copper and manganese was associated with a greater prevalence of metabolic syndrome. Future prospective studies are needed to confirm the importance of achieving copper and manganese adequacy and synergistic aspects of foods containing these minerals for optimal cardiometabolic health.

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