Non-obese (body mass index < 25 kg/m2) Asian Indians with normal waist circumference have high cardiovascular risk

Objective Although the prevalence of obesity is not high in Asian Indians, increased prevalence rates of metabolic perturbations and cardiovascular risk factors have been reported. In this study, we evaluated body mass index (BMI), anthropometric measurements, and body fat profiles of obese and non-obese subjects and correlated those values with cardiovascular risk factors. Methods This cross-sectional study involved 639 subjects (170 men and 469 women) from low socioeconomic stratum residing in urban slums of New Delhi. Non-obese subjects were categorized into quartiles of percentage of body fat (%BF) and waist circumference (WC). Using logistic regression analysis, the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of cardiovascular risk factors (diabetes mellitus [DM], hypertension, hypercholesterolemia, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, and high levels of low-density lipoprotein cholesterol) were computed with first quartile in the non-obese group as the reference category for the following five categories: %BF and WC quartiles in the non-obese group and obese group (BMI ≥ 25 kg/m2). Results In the non-obese group, approximately 66% of men and 88% of women had at least one risk factor. In non-obese women, significantly high ORs and 95% CIs were found for hypertension (3.2, 1.4–7.2), DM (2.8, 1.2–6.3), and hypertriglyceridemia (3.9, 1.9–8.3) in the upper quartiles of %BF, and significantly high OR (95% CIs) was observed for hypertriglyceridemia (3.9, 1.4–10.8) in non-obese men. Among non-obese men, significantly high OR (95% CIs) was found for hypertriglyceridemia (3.2, 1.0–10.3); among non-obese women, significantly high ORs (95% CIs) were observed for hypertension (2.5, 1.1–5.8) and hypertriglyceridemia (2.5, 1.2–5.2) in the normal range of WC (70–80 cm). Conclusion The study showed that Asian Indians have excess cardiovascular risk at BMI and WC values considered “normal.” These data suggested that definitions of “normal” ranges of BMI and WC need to be revised for Asian Indians.