Background Ethnic variation in abdominal fat distribution may explain differences in cardiometabolic risk between populations. However, the ability of anthropometric measures to quantify abdominal fat is not clearly understood across ethnic groups. The aim of this study was to investigate the associations between anthropometric measures and visceral (VAT) and subcutaneous abdominal adipose tissue (SAT) in Inuit, Africans and Europeans.
Methods We combined cross-sectional data from 3 studies conducted in Greenland, Kenya and Denmark using similar methodology. A total of 5275 individuals (3083 Inuit, 1397 Africans and 795 Europeans) aged 17–95 years with measures of anthropometry and ultrasonography of abdominal fat were included in the study. Multiple regression models with fractional polynomials were used to analyse VAT and SAT as functions of body mass index (BMI), waist circumference, waist-to-hip ratio, waist-to-height ratio and body fat percentage.
Results The associations between conventional anthropometric measures and abdominal fat distribution varied by ethnicity in almost all models. Europeans had the highest levels of VAT in adjusted analyses and Africans the lowest with ethnic differences most apparent at higher levels of the anthropometric measures. Similar ethnic differences were seen in the associations with SAT for a given anthropometric measure.
Conclusions Conventional anthropometric measures like BMI and waist circumference do not reflect the same amount of VAT and SAT across ethnic groups. Thus, the obesity level at which Inuit and Africans are at increased cardiometabolic risk is likely to differ from that of Europeans.
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Contributors MEJ, DLC and MA designed the studies and collected data; PFR and BC analysed the data; PFR wrote the paper; MA, TL, MEJ, DLC and GSA contributed to interpretation of results and edited the paper; PFR had primary responsibility for the final content. All authors read and approved the final manuscript.
Funding The Inuit Health in Transition (IHIT) Study was supported by Karen Elise Jensen's Foundation, NunaFonden, Medical Research Council of Denmark, Medical Research Council of Greenland, and the Commission for Scientific Research in Greenland. Health2008 was supported by the Timber Merchant Vilhelm Bang's Foundation, the Danish Heart Foundation and the Health Insurance Foundation. The Kenya Diabetes Study was supported by DANIDA, Cluster of International Health (University of Copenhagen), Steno Diabetes Center, Beckett Foundation, Dagmar Marshall Foundation, Dr Thorvald Madsen's Grant, Kong Christian den Tiende's Foundation and Brdr. Hartmann Foundation. PFR was funded by the Centre for Arctic Health (Aarhus University).
Competing interests None declared.
Ethics approval Ethical Review Committee for Greenland, the National Ethical Review Committee in Kenya, the Danish National Committee on Biomedical Research Ethics in Denmark, Ethics Committee of the Copenhagen Region.
Provenance and peer review Not commissioned; externally peer reviewed.