Musa Imad R, Osman Osman E, Khair Ahmed M, Adam Ishag
Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia.
Faculty of Medicine, Alneelain University, Khartoum, Sudan.
BMC Public Health. 2025 Jan 14;25(1):142. doi: 10.1186/s12889-025-21276-8.
Hypertension is an increasing health problem; hence, efforts have been made to promote the disease's early detection and modify prognoses. We aim to evaluate the accuracy of body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) in detecting hypertension among adults in Northern Sudan.
Adults were recruited for a multi-stage sampling survey in Northern Sudan. Sociodemographic and anthropometric index (BMI, WC, and WHtR) information were collected. A receiver operating characteristic (ROC) curve with its area under the curve (AUC) was obtained, and a multivariate binary analysis was performed.
Of the 301 included adults, 113 (37.5%) were females and 188 (62.5%) were males. The median (interquartile range, IQR) age was 45.0 (32.0‒59.0) years. The median (IQR) of BMI, WC, and WHtR was 25.6 (21.9‒29.7) kg/m, 83.0 (73.0‒94.8) cm, and 0.51 (0.43‒0.58), respectively; these values were significantly higher in adults with hypertension compared with adults without hypertension. A total of 166 (55.1%) adults had hypertension. BMI (AUC = 0.69 at the cutoff 22.5 kg/m, sensitivity = 0.89, specificity = 0.53, YI = 0.35) and WHtR for both males and females (AUC = 0.68 at the cutoff 0.48, sensitivity = 0.75, specificity = 0.60, YI = 0.35) were more accurate than WC (AUC = 0.66 at the cutoff 77.5 cm, sensitivity = 0. 77, specificity = 0.56, YI = 0.33). The multivariate binary analysis revealed that being female (adjusted odds ratio [AOR] = 2.23, 95.0% CI = 1.25‒3.97), having increased age (AOR = 1.04, 95% CI = 1.02‒1.05), and having a higher BMI (AOR = 1.10, 95% CI = 1.04‒1.16) were associated with hypertension.
BMI, WC, and WHtR showed moderate predictive power, suggesting that these indices have a limited role in diagnosing hypertension at the individual level and are more appropriate for population screening than for individual diagnosis. BMI performs better than WC in terms of hypertension detection.
高血压是一个日益严重的健康问题；因此，人们一直在努力促进疾病的早期检测并改善预后。我们旨在评估体重指数（BMI）、腰围（WC）和腰高比（WHtR）在苏丹北部成年人中检测高血压的准确性。
在苏丹北部招募成年人进行多阶段抽样调查。收集社会人口统计学和人体测量指标（BMI、WC和WHtR）信息。获得了带有曲线下面积（AUC）的受试者工作特征（ROC）曲线，并进行了多变量二元分析。
在纳入的301名成年人中，113名（37.5%）为女性，188名（62.5%）为男性。年龄中位数（四分位间距，IQR）为45.0（32.0 - 59.0）岁。BMI、WC和WHtR的中位数（IQR）分别为25.6（21.9 - 29.7）kg/m、83.0（73.0 - 94.8）cm和0.51（0.43 - 0.58）；与无高血压的成年人相比，高血压成年人的这些值显著更高。共有166名（55.1%）成年人患有高血压。BMI（在临界值22.5 kg/m时AUC = 0.69，灵敏度 = 0.89，特异性 = 0.53，YI = 0.35）以及男性和女性的WHtR（在临界值0.48时AUC = 0.68，灵敏度 = 0.75，特异性 = 0.60，YI = 0.35）比WC（在临界值77.5 cm时AUC = 0.66，灵敏度 = 0.77，特异性 = 0.56，YI = 0.33）更准确。多变量二元分析显示，女性（调整优势比[AOR] = 2.23，95.0% CI = 1.25 - 3.97）、年龄增加（AOR = 1.04，95% CI = 1.02 - 1.05）以及BMI较高（AOR = 1.10，95% CI = 1.04 - 1.16）与高血压相关。
BMI、WC和WHtR显示出中等预测能力，表明这些指标在个体水平诊断高血压方面作用有限，更适合人群筛查而非个体诊断。在检测高血压方面，BMI比WC表现更好。
