Is waist circumference ≥ 102/88 cm better than body mass index ≥ 30 to predict hypertension and diabetes development regardless of gender, age group, and race/ethnicity? Meta-analysis

- WC ≥ 102/88 cm is better than BMI ≥ 30 in predicting diabetes but not hypertension.
- WC ≥ 102/88 cm, not BMI ≥ 30, predicted hypertension in Hispanic/Latinos.
- Heterogeneity between obesity and disease is partly due to age and race/ethnicity.

Between body mass index (BMI) ≥ 30 and waist circumference (WC) ≥ 102/88 cm, we investigated which of the two measures is a better predictor of two of the most common chronic diseases - diabetes mellitus and hypertension while also examining differential association by gender, age group, and race/ethnicity. Meta-analysis was conducted for all longitudinal studies with at least 12 months of follow-up published up to April 2015. Ratio of relative risk (rRR) and relative risk of diseases were computed and compared by baseline obesity measurement. The final sample included 23 longitudinal observation studies involving 62 study arms with 259,200 individuals. WC ≥ 102/88 cm was a better predictor than BMI ≥ 30 for development of diabetes (rRR = 0.81, 95% CI = 0.68-0.96), but not for hypertension (rRR = 0.92, 95% CI = 0.80-1.06). Subgroup analyses showed WC ≥ 102/88 cm was a better predictor for diabetes in women than men, and for ages 60 and older than other ages. Only WC ≥ 102/88 cm, not BMI ≥ 30, predicted development of hypertension among Hispanic/Latinos. Neither BMI ≥ 30 nor WC ≥ 102/88 cm were significant predictors of hypertension when age group was controlled. Central obesity may be a more serious risk factor for diabetes development in women and for older ages. The predictive power of BMI ≥ 30 or WC ≥ 102/88 cm in hypertension development should not be emphasized as either could mask the effect of age.