Derivation of anthropometric cut-off levels to define CVD risk in Sri Lankan adults.

Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative sample of 4474 non-institutionalised adults aged ≥ 18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood samples were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors (P < 0·001). Cut-off values for BMI, WC and WHR for males were 20·7 kg/m2, 76·5 cm and 0·89, respectively. The respective values for females were 22·0 kg/m2, 76·3 cm and 0·85. The common cut-off value for BMI for males and females was 21·5 kg/m2. Similarly, WC and WHR cut-off values for both males and females were 76·3 cm and 0·87, respectively. The Asian and Caucasian anthropometric cut-off levels showed lower sensitivity and higher false negative percentage compared with newly derived cut-off levels. In conclusion, BMI, WC and WHR were all associated with increased CVD risk. We propose the following anthropometric cut-off points to determine high CVD risk level for Sri Lankan adults: BMI ≥ 21·5 kg/m2, WC ≥ 76 cm and WHR ≥ 0·85 (women) and 0·90 (men).

Prevalence of overweight and obesity in Sri Lankan adults.

The aim of the study was to determine the prevalence of overweight, obesity and abdominal obesity, and the underlying socio-demographic correlates among Sri Lankan adults. Data were from 4532 adults aged ≥18 years randomly selected for a national level study on diabetes and cardiovascular disease. Weight, height and waist circumference (WC) were measured and body mass index (BMI) calculated. The mean (95% confidence interval) BMI and WC were 21.1 kg m(-2) (20.9-21.3), 22.3 kg m(-2) (22.1-22.4) and 78.0 cm (77.5-78.6) and 77.5 cm (77.0-78.0) for males and females, respectively. According to the proposed World Health Organization cut-off values for Asians, the percentage of Sri Lankan adults in the overweight, obese and centrally obese categories were 25.2%, 9.2% and 26.2%, respectively. Based on the cut-offs for Caucasians, these were 16.8%, 3.7% and 10.8%. Our findings were compatible with prevalence of obesity in regional countries. In addition, female sex, urban living, higher education, higher income and being in the middle age were shown to be associated with overweight and obesity in Sri Lankans. In conclusion, we have documented a relatively high prevalence of overweight and obesity, particularly, abdominal obesity among adults in Sri Lanka which is a middle-income country. Urgent public health interventions are needed to control the problem at an early stage.