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Waist circumference and low high-density lipoprotein cholesterol as markers of cardiometabolic risk in Kenyan adults

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  • Daniel Faurholt-Jepsen
  • Henrik Friis
  • David L. Mwaniki
  • Michael K. Boit
  • Lydia U. Kaduka
  • Inge Tetens
  • Dirk L. Christensen
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BACKGROUND: Abdominal obesity predict metabolic syndrome parameters at low levels of waist circumference (WC) in Africans. At the same time, the African lipid profile phenotype of low high-density lipoprotein (HDL) cholesterol without concomitant elevated triglyceride levels renders high triglyceride levels detrimental to cardiometabolic health unsuitable for identifying cardiometabolic risk in black African populations.

OBJECTIVES: We aimed to identify simple clinical measures for cardiometabolic risk based on WC and HDL in an adult Kenyan population in order to determine which of the two predictors had the strongest impact.

METHODS: We used linear regression analyses to assess the association between the two exposure variables WC and HDL with cardiometabolic risk factors including ultrasound-derived visceral (VAT) and subcutaneous adipose tissue (SAT) accumulation, fasting and 2-h venous glucose, fasting insulin, fasting lipid profile, and blood pressure in adult Kenyans (n = 1 370), and a sub-population with hyperglycaemia (diabetes and pre-diabetes) (n = 196). The same analyses were performed with an interaction between WC and HDL to address potential effect modification. Ultrasound-based, semi-quantitative hepatic steatosis assessment was used as a high-risk measure of cardiometabolic disease.

RESULTS: Mean age was 38.2 (SD 10.7) (range 17-68) years, mean body mass index was 22.3 (SD 4.5) (range 13.0-44.8) kg/m2, and 57.8% were women. Cardiometabolic risk was found in the association between both WC and HDL and all outcome variables (p<0.05) except for HDL and SAT, fasting and 2-h venous glucose. Additive cardiometabolic risk (WC and HDL interaction) was found for SAT, low-density lipoprotein cholesterol, and triglycerides. No differences in the association between WC and HDL and the outcome variables were found when comparing the full study population and the hyperglycaemia sub-population. Increase in WC and HDL were both associated with hepatic steatosis (OR 1.09, p<0.001, and OR 0.46, p = 0.031, respectively).

CONCLUSION: In adult Kenyans, increasing WC identified more cardiometabolic risk factors compared to HDL.

TidsskriftPLoS One
Udgave nummer2
Sider (fra-til)e0247600
StatusUdgivet - feb. 2021

Bibliografisk note

Publisher Copyright:
© 2021 Faurholt-Jepsen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Copyright 2021 Elsevier B.V., All rights reserved.

ID: 66495940