OBJECTIVE:To determine values of simple anthropometric measurements which are associated with the presence of type 2 diabetes mellitus, hypertension and dyslipidaemia and to assess anthropometric cut-off values for predicting the likelihood of these chronic conditions in a Mexican population. DESIGN AND SETTING: The data were obtained from PRIT (Prevalence of Cardiovascular Risk Factors in General Hospital Workers) surveys from 1994 to 2000 adjusted to the structure of the overall Mexican population. SUBJECTS: A total of 2426 men and 5939 women aged 38.99 AE 7.11 and 39.11 AE 14.25 y, respectively. MEASUREMENTS: The optimal sensitivity and specificity of using various cut-off values of BMI (body mass index), WHR (waistto-hip ratio), WC (waist circumference) and WTH (waist-to-height ratio) to predict type 2 diabetes mellitus (DM), hypertension (HT), or dyslipidaemia were examined by receiver operating characteristic curve (ROC) analysis. The likelihood ratios for having diabetes, hypertension and dyslipidaemia in subjects with various cut-off values of BMI, WHR, WC and WTH were calculated. Multiple step-wise logistic regression analysis was used to examine the independent relationship between the anthropometric indexes, age and smoking, and the odds ratio of having chronic conditions. RESULTS: The BMI cut-off to predict DM, HT, or dyslipidaemia varied from 25.2 to 26.6 kg=m 2 in both men and women. The optimal WC cut-offs were 90 cm in men and 85 cm in women. The WHR cut-off was about 0.90 in men and 0.85 in women, and the optimal WTH cut-off was 52.5 in men and varied from 53 to 53.5 in women. The cut-off levels for WC, WHR and WTH corresponded to the inflexion points in the likelihood ratio graphs. In the case of BMI likelihood ratio graphs, we found a significant increase in the risk for chronic conditions from 22 to 23 BMI levels in both genders. Logistic regression analyses disclosed that only BMI and age were included in all the models as well as the influence of smoking in DM and dyslipidaemia in men. CONCLUSION: Although these results may not be readily applied to the rest of the Mexican population or to other Hispanic populations, they point to the necessity of similar studies with large randomized samples to find the cut-off levels for chronic conditions in different populations.

This 6-month randomized study evaluated the safety and efficacy of sibutramine in 57 overweight Hispanic patients with hypertension. Following a 2-week washout to confirm the diagnosis of hypertension, antihypertensive medication was adjusted to achieve a blood pressure less than 140/90 mm Hg before institution of either sibutramine 10 mg or placebo once a day. A body mass index in excess of 27 kg/m2 was required for entry. At study end, weight had changed from 75.4+/-9.6 to 70.0+/-9.5 kg in the sibutramine group and from 77.9+/-9.0 to 74.5+/-9.4 kg in the placebo group. In the sibutramine group, systolic blood pressure was 127.8+/-5.8 mm Hg after stabilization and 125.2+/-8.5 mm Hg after completion of the trial; respective values for diastolic blood pressure were 82.4+/-3.7 and 81.5+/-4.6 mm Hg. With placebo, blood pressure dropped from 129.0+/-7.1/80.9+/-4.9 mm Hg to 122.8+/-9.7/80.3+/-5.4 mm Hg at the same timepoints. In the sibutramine group, 14 patients reported 21 adverse events, most frequently headache (n=5), constipation (n=4), and dry mouth (n=4). In the placebo group, 13 patients had 20 adverse events. Sibutramine is safe and effective in overweight Hispanic patients with hypertension, but monitoring of blood pressure and titration of antihypertensive medication are necessary.

FANGHÄ NEL, GUILLERMO, LETICIA SÁ NCHEZ-REYES, ARTURO BERBER, AND ROSARIO GÓ MEZ-SANTOS. Evolution of the prevalence of obesity in the workers of a general hospital in Mexico. Obes Res. 2001;9: 268 -273. Objective: The objective of this study was to compare the prevalence of overweight and obesity in the first Prevalencia de factores de nesso cardiovascular en Trabajadores survey (1994) with the prevalence of overweight and obesity observed in the second survey (1996). Research Methods and Procedures: For both surveys the following individual data were collected: age, sex, weight, height, and body mass index (BMI). The 1994 survey included 2383 people and the 1996 survey included 2759 people. The degree of BMI was classified according to the current World Health Organization definitions. The population was divided by gender and age group, and the prevalence of each level of overweight was calculated. Additionally, the prevalence of different cutoff levels of BMI was calculated by gender and age groups. Results: The global prevalence of age-adjusted overweight increased from 26.91% to 37.45%. This increase was observed in both genders but the men had a higher increase from 24.51% to 40.21%. Overweight was more frequent in men than in women in all age groups. Male overweight prevalence was higher in the 40-to 59-year-old group and Ն60-year-old group. Female overweight prevalence was predominant in the 30-to 39-year-old, 40-to 49-year-old, and 50-to 59-year-old groups. Global prevalence of obesity (Ն30 kg/m 2 ) changed from 13.8% to 17.2%. Particularly, global prevalence of obesity class I increased from 9.66% to 12.6%; in men this figure increased from 9.04% to 13.05% and in women from 9.9% to 12.71%. Discussion:Prevalence of overweight and obesity has increased significantly in the studied population. It is necessary to implement lifestyle modifications to prevent the increase of prevalence of overweight and obesity.