Bioelectrical impedance outperforms waist circumference for predicting cardiometabolic risk in Congolese hypertensive subjects: a cross-sectional study

Abstract

BackgroundWaist circumference threshold values used in sub-Saharan Africa correspond to those of European populations and are therefore inappropriate. Thus, they may over predict insulin resistance, especially in hypertensive Africans, in whom there is often no association between blood pressure and insulin resistance. Using bioelectrical impedance measurement in sub-Saharan Africa could possibly be advantageous to overcome the shortcomings of waist circumference measurement. The aim of this study was to evaluate the contribution of body composition estimation by bioelectrical impedance to predict cardiometabolic risk in Congolese hypertensive subjects.MethodsCardiovascular profiling and body composition analysis by bioelectrical impedance was measured in 400 patients (men = 40%; age = 51.1 ± 12.6 years). Patients were diagnosed with a metabolic syndrome (MS) according to the IDF Criteria with and without the “blood pressure” criterion to remove any confounding autocorrelation bias, a visceral fat-MS (with and without the “blood pressure” criterion) being defined by the presence of ≥ 2 criteria with the precondition of excess visceral fat defined by a bio impedance measurement score >10/30. Total cardiovascular risk was assessed using the criteria of Framingham-2008.ResultsThe frequencies of enlarged waist circumference (71.9% vs 68.9%, p = 0.52) and IDF-MS without blood pressure criterion (24.9% vs 21.9%, p = 0.48) were similar among hypertensive vs. non hypertensive however excess visceral fat (57.6% vs 33.8%, p <0.0001) as well as visceral fat-MS without blood pressure criterion (18.9% vs 11.3%, p = 0.04) were more prevalent among hypertensive. Finally, total cardiovascular risk as well as arterial hypertension risk were associated with visceral fat, but not with waist circumference (p > 0.05).ConclusionsPending the determination of thresholds values for pathological waist circumference adapted to sub-Saharan populations, using bioelectrical impedance measurement may contribute to better characterize the cardiometabolic risk and the insulin resistant phenotype of hypertensive sub-Saharan Africans.

Does visceral fat affect aerobic fitness in Indian adolescents of 18-19 years' age group?

“…The height was measured using a meter scale without footwear to the nearest 0.1 cm. [23] Waist circumference (WC) was measured at the midpoint between the lower costal margin and the highest point on the iliac crest to the nearest 0.5 cm at the end of normal expiration. [22] Body weight, total body fat (TBF) percentage, and visceral fat were measured by bioelectrical impedance technique using Omron HBF-302 body fat analyzer.…”

“…Volunteers with visceral fat 0-9 were categorized as a normal visceral fat group, and volunteers with visceral fat ≥10 was categorized as a high visceral fat group for both the genders. [23] Calculations of VO 2 max by Bruce Protocol Estimation of maximum oxygen utilization was done using motorized treadmill machine following the standard Bruce Protocol as per proposed guidelines of the American Heart Association. [21] Bruce's treadmill exercise test is a continuous, incremental test which consists of total 7 stages, and each stage continues for 3 min.…”

Effects of Different Aerobic Exercise Programs with Nutritional Intervention in Primary Hypertensive and Overweight/Obese Adults: EXERDIET-HTA Controlled Trial

“…Nevertheless, BMI does not account for the wide variation in body fat distribution. Therefore, measurement of waist circumference provides a simple and practical method to add to BMI along with additional tools such as measuring body composition (i.e., electrical bioimpedance [8]) or energy intake [9].…”