Sex Difference in the Associations among Obesity-Related Indices with Incident Hypertension in a Large Taiwanese Population Follow-Up Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Taiwan Biobank
2.2. Definition of Incident Hypertension
2.3. Calculation of Obesity-Related Indices
- BMI was calculated as:
- 2.
- WHR was calculated as:
- 3.
- WHtR was calculated as:
- 4.
- BRI was calculated as:
- 5.
- CI was calculated using the Valdez equation based on BW, BH and WC as:
- 6.
- BAI was calculated according to the method of Bergman and colleagues as:
- 7.
- AVI was calculated as AVI = [37].
- 8.
- LAP was calculated as:
- 9.
- VAI score was calculated as described previously [39] using the following sex-specific equations (with TG levels in mmol/L and HDL-cholesterol levels in mmol/L):
2.4. Statistical Analysis
3. Results
3.1. Comparisons of Clinical Characteristics between the Participants by Sex
3.2. Comparisons of Clinical Characteristics between the Participants with and without Incident Hypertension by Sex
3.3. Associations among Obesity-Related Indices with Incident Hypertension by Sex
3.4. Interactions among Obesity-Related Indices and Sex on Incident Hypertension
3.5. Performance and Predictive Ability of the Obesity-Related Indices to Identify Incident Hypertension by Sex
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Male (n = 6899) | Female (n = 14,567) | p |
---|---|---|---|
Age (year) | 49.6 ± 10.9 | 49.7 ± 10.0 | 0.465 |
DM (%) | 5.0 | 2.8 | <0.001 |
Smoking history (%) | 57.8 | 7.9 | <0.001 |
Alcohol history (%) | 6.9 | 0.7 | <0.001 |
Regular exercise habits (%) | 46.2 | 46.1 | 0.876 |
Systolic BP (mmHg) | 116.1 ± 11.5 | 110.0 ± 13.3 | <0.001 |
Diastolic BP (mmHg) | 73.8 ± 8.2 | 67.9 ± 8.7 | <0.001 |
Body height (cm) | 169.2 ± 6.3 | 157.2 ± 5.5 | <0.001 |
Body weight (Kg) | 70.6 ± 10.6 | 57.3 ± 8.9 | <0.001 |
Waist circumference (cm) | 86.1 ± 8.5 | 79.9 ± 9.1 | <0.001 |
Hip circumference (cm) | 96.6 ± 6.2 | 94.6 ± 6.6 | <0.001 |
Laboratory parameters | |||
Fasting glucose (mg/dL) | 98.2 ± 22.2 | 92.8 ± 16.5 | <0.001 |
Hemoglobin (g/dL) | 15.0 ± 1.1 | 13.0 ± 1.3 | <0.001 |
Triglyceride (mg/dL) | 128.6 ± 98.9 | 98.1 ± 67.0 | <0.001 |
Total cholesterol (mg/dL) | 191.8 ± 34.4 | 196.6 ± 35.7 | <0.001 |
HDL-cholesterol (mg/dL) | 48.6 ± 11.1 | 58.4 ± 13.0 | <0.001 |
LDL-cholesterol (mg/dL) | 122.7 ± 31.4 | 120.7 ± 31.7 | <0.001 |
eGFR (mL/min/1.73 m2) | 100.9 ± 20.0 | 116.0 ± 25.6 | <0.001 |
Uric acid (mg/dL) | 6.4 ± 1.3 | 4.8 ± 1.1 | <0.001 |
Obesity-related indices | |||
BMI (kg/m2) | 24.6 ± 3.2 | 23.2 ± 3.4 | <0.001 |
WHR (%) | 89.0 ± 5.4 | 84.3 ± 6.6 | <0.001 |
WHtR (%) | 50.9 ± 5.0 | 50.8 ± 6.0 | 0.335 |
BRI | 6.9 ± 1.6 | 6.3 ± 1.8 | <0.001 |
CI | 1.22 ± 0.06 | 1.22 ± 0.08 | <0.001 |
BAI | 26.0 ± 3.0 | 30.1 ± 3.7 | <0.001 |
AVI | 15.1 ± 3.0 | 13.1 ± 2.9 | <0.001 |
LAP | 33.1 ± 33.7 | 26.1 ± 25.4 | <0.001 |
VAI | 1.67 ± 1.75 | 1.55 ± 1.52 | <0.001 |
Characteristics | Male (n = 6899) | Female (n = 14,567) | ||||
---|---|---|---|---|---|---|
Incident Hypertension (−) (n = 5530) | Incident Hypertension (+) (n = 1369) | p | Incident Hypertension (−) (n = 12,775) | Incident Hypertension (+) (n = 1792) | p | |
Age (year) | 48.5 ± 10.9 | 54.0 ± 10.0 | <0.001 | 48.9 ± 9.9 | 55.5 ± 8.5 | <0.001 |
DM (%) | 4.3 | 7.7 | <0.001 | 2.5 | 5.7 | <0.001 |
Smoking history (%) | 56.9 | 61.7 | 0.001 | 8.2 | 5.7 | <0.001 |
Alcohol history (%) | 6.5 | 8.9 | 0.001 | 0.7 | 0.6 | 0.615 |
Regular exercise habits (%) | 44.8 | 52.0 | <0.001 | 45.1 | 53.3 | <0.001 |
Systolic BP (mmHg) | 113.9 ± 10.9 | 124.8 ± 9.4 | <0.001 | 108.1 ± 12.4 | 124.0 ± 10.5 | <0.001 |
Diastolic BP (mmHg) | 72.7 ± 8.0 | 78.5 ± 7.4 | <0.001 | 66.9 ± 8.3 | 74.9 ± 8.3 | <0.001 |
Body height (cm) | 169.5 ± 6.2 | 167.9 ± 6.4 | <0.001 | 157.5 ± 5.6 | 155.7 ± 5.2 | <0.001 |
Body weight (Kg) | 70.2 ± 10.5 | 72.0 ± 10.7 | <0.001 | 56.9 ± 8.7 | 59.8 ± 9.7 | <0.001 |
Waist circumference (cm) | 85.5 ± 8.5 | 88.5 ± 8.2 | <0.001 | 79.3 ± 8.9 | 83.7 ± 9.4 | <0.001 |
Hip circumference (cm) | 96.4 ± 6.2 | 97.5 ± 6.3 | <0.001 | 94.4 ± 6.5 | 96.1 ± 7.3 | <0.001 |
Laboratory parameters | ||||||
Fasting glucose (mg/dL) | 97.3 ± 20.6 | 101.7 ± 27.4 | <0.001 | 92.1 ± 15.4 | 97.8 ± 22.7 | <0.001 |
Hemoglobin (g/dL) | 15.0 ± 1.1 | 15.1 ± 1.2 | 0.038 | 12.9 ± 1.3 | 13.2 ± 1.3 | <0.001 |
Triglyceride (mg/dL) | 124.7 ± 97.0 | 144.3 ± 104.7 | <0.001 | 95.4 ± 62.4 | 117.9 ± 90.7 | <0.001 |
Total cholesterol (mg/dL) | 191.1 ± 34.5 | 194.9 ± 33.8 | <0.001 | 195.7 ± 35.5 | 203.0 ± 36.5 | <0.001 |
HDL-cholesterol (mg/dL) | 49.0 ± 11.3 | 47.2 ± 10.5 | <0.001 | 58.7 ± 13.0 | 55.8 ± 12.7 | <0.001 |
LDL-cholesterol (mg/dL) | 122.2 ± 31.3 | 124.7 ± 31.9 | <0.001 | 119.9 ± 31.4 | 126.6 ± 33.1 | <0.001 |
eGFR (mL/min/1.73 m2) | 101.8 ± 19.7 | 97.4 ± 21.1 | <0.001 | 116.8 ± 25.5 | 110.2 ± 25.6 | <0.001 |
Uric acid (mg/dL) | 6.3 ± 1.3 | 6.6 ± 1.4 | <0.001 | 4.8 ± 1.0 | 5.2 ± 1.1 | <0.001 |
Obesity-related indices | ||||||
BMI (kg/m2) | 24.4 ± 3.1 | 25.5 ± 3.1 | <0.001 | 22.9 ± 3.3 | 24.6 ± 3.6 | <0.001 |
WHR (%) | 88.6 ± 5.4 | 90.7 ± 5.0 | <0.001 | 84.0 ± 6.5 | 87.1 ± 6.5 | <0.001 |
WHtR (%) | 50.5 ± 5.0 | 52.7 ± 4.8 | <0.001 | 50.4 ± 5.9 | 53.8 ± 6.1 | <0.001 |
BRI | 6.8 ± 1.6 | 7.4 ± 1.6 | <0.001 | 6.2 ± 1.7 | 7.1 ± 1.9 | <0.001 |
CI | 1.22 ± 0.06 | 1.24 ± 0.06 | <0.001 | 1.21 ± 0.08 | 1.24 ± 0.09 | <0.001 |
BAI | 25.8 ± 2.9 | 26.8 ± 3.1 | <0.001 | 29.9 ± 3.6 | 31.5 ± 3.9 | <0.001 |
AVI | 14.9 ± 2.9 | 15.9 ± 2.9 | <0.001 | 12.9 ± 2.9 | 14.3 ± 3.2 | <0.001 |
LAP | 31.3 ± 32.3 | 40.4 ± 37.9 | <0.001 | 24.7 ± 23.3 | 35.8 ± 35.7 | <0.001 |
VAI | 1.61 ± 1.72 | 1.93 ± 1.86 | <0.001 | 1.49 ± 1.40 | 1.97 ± 2.19 | <0.001 |
Obesity-Related Indices | Male (n = 6899) | Male (n = 6899) | ||||
---|---|---|---|---|---|---|
Crude | Age-Adjusted | |||||
OR | 95% Confidence Interval | p | OR | 95% Confidence Interval | p | |
BMI (per 1 kg/m2) | 1.108 | 1.088–1.128 | <0.001 | 1.140 | 1.118–1.162 | <0.001 |
WHR (per 0.01) | 1.077 | 1.065–1.090 | <0.001 | 1.060 | 1.048–1.072 | <0.001 |
WHtR (per 0.01) | 1.092 | 1.079–1.105 | <0.001 | 1.083 | 1.070–1.097 | <0.001 |
BRI (per 1) | 1.267 | 1.222–1.313 | <0.001 | 1.265 | 1.219–1.313 | <0.001 |
CI (per 0.1) | 1.722 | 1.565–1.894 | <0.001 | 1.455 | 1.318–1.606 | <0.001 |
BAI (per 1) | 1.127 | 1.105–1.150 | <0.001 | 1.113 | 1.091–1.136 | <0.001 |
AVI (per 1) | 1.116 | 1.095–1.138 | <0.001 | 1.130 | 1.108–1.154 | <0.001 |
LAP (per 1) | 1.007 | 1.005–1.009 | <0.001 | 1.008 | 1.007–1.010 | <0.001 |
VAI (per 1) | 1.092 | 1.058–1.127 | <0.001 | 1.111 | 1.074–1.149 | <0.001 |
Obesity-Related Indices | Female (n = 14,567) | Female (n = 14,567) | ||||
---|---|---|---|---|---|---|
Crude | Age-Adjusted | |||||
OR | 95% Confidence Interval | p | OR | 95% Confidence Interval | p | |
BMI (per 1 kg/m2) | 1.141 | 1.126–1.157 | <0.001 | 1.150 | 1.134–1.167 | <0.001 |
WHR (per 0.01) | 1.072 | 1.064–1.080 | <0.001 | 1.044 | 1.036–1.052 | <0.001 |
WHtR (per 0.01) | 1.091 | 1.082–1.099 | <0.001 | 1.071 | 1.062–1.080 | <0.001 |
BRI (per 1) | 1.293 | 1.261–1.325 | <0.001 | 1.235 | 1.203–1.269 | <0.001 |
CI (per 0.1) | 1.483 | 1.401–1.570 | <0.001 | 1.204 | 1.134–1.278 | <0.001 |
BAI (per 1) | 1.119 | 1.105–1.134 | <0.001 | 1.104 | 1.089–1.119 | <0.001 |
AVI (per 1) | 1.151 | 1.134–1.169 | <0.001 | 1.130 | 1.112–1.149 | <0.001 |
LAP (per 1) | 1.014 | 1.012–1.015 | <0.001 | 1.011 | 1.009–1.012 | <0.001 |
VAI (per 1) | 1.168 | 1.134–1.203 | <0.001 | 1.123 | 1.091–1.157 | <0.001 |
Obesity-Related Indices | Male (n = 6899) | Female (n = 14,567) | |||||
---|---|---|---|---|---|---|---|
Multivariable | Multivariable | ||||||
OR | 95% Confidence Interval | p | OR | 95% Confidence Interval | p | Interaction p | |
BMI (per 1 kg/m2) a | 1.107 | 1.083–1.131 | <0.001 | 1.119 | 1.101–1.137 | <0.001 | 0.010 |
WHR (per 0.01) a | 1.038 | 1.024–1.051 | <0.001 | 1.027 | 1.018–1.035 | <0.001 | 0.477 |
WHtR (per 0.01) a | 1.062 | 1.048–1.077 | <0.001 | 1.053 | 1.043–1.062 | <0.001 | 0.890 |
BRI (per 1) a | 1.190 | 1.141–1.241 | <0.001 | 1.166 | 1.131–1.201 | <0.001 | 0.369 |
CI (per 0.1) a | 1.237 | 1.112–1.375 | <0.001 | 1.095 | 1.028–1.166 | 0.005 | 0.008 |
BAI (per 1) a | 1.084 | 1.061–1.107 | <0.001 | 1.078 | 1.062–1.093 | <0.001 | 0.574 |
AVI (per 1) a | 1.092 | 1.068–1.117 | <0.001 | 1.090 | 1.071–1.110 | <0.001 | 0.013 |
LAP (per 1) b | 1.008 | 1.005–1.111 | <0.001 | 1.010 | 1.007–1.013 | <0.001 | <0.001 |
VAI (per 1) c | 1.084 | 1.041–1.128 | <0.001 | 1.095 | 1.062–1.128 | <0.001 | 0.002 |
Obesity-Related Indices | AUC (95% Confidence Interval) | Cutoff Value | Sensitivity (%) | Specificity (%) | Youden Index |
---|---|---|---|---|---|
BMI (kg/m2) | 0.597 (0.581–0.614) * | 24.700 | 56.7 | 56.7 | 0.134 |
WHR | 0.618 (0.602–0.634) * | 0.897 | 58.7 | 58.7 | 0.174 |
WHtR | 0.632 (0.616–0.648) * | 0.514 | 59.3 | 59.1 | 0.184 |
BRI | 0.621 (0.605–0.637) * | 6.952 | 58.7 | 58.8 | 0.175 |
CI | 0.600 (0.584–0.617) * | 1.232 | 57.0 | 57.0 | 0.140 |
BAI | 0.605 (0.588–0.621) * | 26.166 | 57.9 | 57.8 | 0.157 |
AVI | 0.604 (0.588–0.620) * | 15.138 | 58.1 | 58.1 | 0.162 |
LAP | 0.610 (0.594–0.626) * | 26.802 | 58.1 | 58.1 | 0.162 |
VAI | 0.582 (0.566–0.599) * | 1.287 | 55.6 | 55.6 | 0.112 |
Obesity-Related Indices | AUC (95% Confidence Interval) | Cutoff Value | Sensitivity (%) | Specificity (%) | Youden Index |
---|---|---|---|---|---|
BMI (kg/m2) | 0.645 (0.632–0.658) * | 23.318 | 60.7 | 60.7 | 0.214 |
WHR | 0.637 (0.624–0.651) * | 0.852 | 60.4 | 60.3 | 0.207 |
WHtR | 0.662 (0.649–0.674) * | 0.516 | 61.5 | 61.5 | 0.230 |
BRI | 0.652 (0.639–0.666) * | 6.409 | 60.9 | 60.8 | 0.217 |
CI | 0.599 (0.585–0.613) * | 1.222 | 57.2 | 57.2 | 0.144 |
BAI | 0.623 (0.610–0.637) * | 30.266 | 58.4 | 58.4 | 0.168 |
AVI | 0.638 (0.624–0.651) * | 13.151 | 59.6 | 59.6 | 0.192 |
LAP | 0.657 (0.644–0.670) * | 23.080 | 61.7 | 61.7 | 0.234 |
VAI | 0.624 (0.610–0.637) * | 1.304 | 59.4 | 59.4 | 0.188 |
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Lee, W.-C.; Wu, P.-Y.; Huang, J.-C.; Tsai, Y.-C.; Chiu, Y.-W.; Chen, S.-C.; Chang, J.-M.; Chen, H.-C. Sex Difference in the Associations among Obesity-Related Indices with Incident Hypertension in a Large Taiwanese Population Follow-Up Study. J. Pers. Med. 2022, 12, 972. https://doi.org/10.3390/jpm12060972
Lee W-C, Wu P-Y, Huang J-C, Tsai Y-C, Chiu Y-W, Chen S-C, Chang J-M, Chen H-C. Sex Difference in the Associations among Obesity-Related Indices with Incident Hypertension in a Large Taiwanese Population Follow-Up Study. Journal of Personalized Medicine. 2022; 12(6):972. https://doi.org/10.3390/jpm12060972
Chicago/Turabian StyleLee, Wen-Chi, Pei-Yu Wu, Jiun-Chi Huang, Yi-Chun Tsai, Yi-Wen Chiu, Szu-Chia Chen, Jer-Ming Chang, and Hung-Chun Chen. 2022. "Sex Difference in the Associations among Obesity-Related Indices with Incident Hypertension in a Large Taiwanese Population Follow-Up Study" Journal of Personalized Medicine 12, no. 6: 972. https://doi.org/10.3390/jpm12060972