Publication Date

2016-07-20

Availability

Open access

Embargo Period

2016-07-20

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2016-02-24

First Committee Member

Neil Schneiderman

Second Committee Member

Maria M. Llabre

Third Committee Member

Marc Gellman

Fourth Committee Member

Ronald Goldberg

Fifth Committee Member

Armando Mendez

Abstract

It is now well established that pronounced differences exist in prevalence of abdominal obesity across gender and ethnicity. Hispanic/Latinos, in particular, have been shown to have markedly distinct prevalence when compared to other ethnic populations around the world. Various organizations have highlighted the need to examine whether overall abdominal obesity cut points are appropriate for the use in this ethnic minority, particular highlighting the need of research among Hispanic/Latino residing in Western countries. This study used data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the largest study of Hispanic/Latinos in the US, to: (1) establish optimal definitions for abdominal obesity among Hispanic/Latino adults, (2) determine the level of agreement between the presence of the metabolic syndrome diagnosed by the current Joint Interim Statement (IJS) definition and an updated definition with optimal abdominal obesity cut points, and (3) examine the association between the presence of the metabolic syndrome, diagnosed by both the IJS and our updated definition, and coronary heart disease (CHD). The sample was comprised of 16,289 individuals (59.94% female). Our results indicate than among US Hispanic/Latino adults, waist circumference cut points of >102 cm in men and >97 cm in women provide optimal discrimination for cardiovascular risk as judged by the presence of CHD. When using these cut points to create an updated metabolic syndrome definition among women, we found disagreement between our updated definition and the current IJS criteria for metabolic syndrome. The prevalence of the metabolic syndrome was overestimated by about 5% points among women based on IJS criteria when compared to our updated definition. Further, we determined that the performance of our updated metabolic syndrome definition as predictor of CHD was comparable to that of the IJS definition. In this paper, we provide for the first time an empirically-derived definition of abdominal obesity for use among Hispanic/Latino adults in the US. Future reports should examine our recommended waist circumference definition cut points and the performance of our updated metabolic syndrome definition as a predictor of cardiovascular risk among US Hispanic/Latinos in prospective designs.

Keywords

Waist circumference; cardiovascular disease; metabolic syndrome; Hispanics

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