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Peer-reviewedCC BY 4.0Frontiers in Public Health

A cross-sectional study on anthropometric indices and hypertension in Chinese adults: comparison of discriminatory power and age-stratified analysis

  • Shiqin Lu1,2
  • Nan Chen3
  • Zhuosong Li1,2
  • Yuanmei Zhang2,4
  • Wenping Wang5
  • Guo Li1
  • Jinglan Hao1
  • Rui Wang1
  • Yanmei Qi3,6
  • Zhengyu Qin1
6 affiliations
  1. 1Health Management Center, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology
  2. 2School of Basic Medical Science, Kunming University of Science and Technology
  3. 3Department of Endocrinology, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology
  4. 4Department of Scientific Research Management, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology
  5. 5Population-wide Health Management Center of Yongren County
  6. 6Health Bureau of Yongren County
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Abstract

Background: Hypertension imposes a heavy public health burden in China. Simple anthropometric indicators help screen hypertension risk, yet the optimal index differs by age. This study compares five adiposity indices including WC, BMI, WHtR, ABSI, and BRI and their age-specific discriminatory ability among Chinese adults.

Materials and methods: In this cross-sectional analysis of 104,248 adults from a health check-up cohort in Southwest China, hypertension was defined as blood pressure ≥140/90 mmHg, a self-reported diagnosis, or current antihypertensive medication use. Multivariable logistic and linear regression models were employed to examine the associations between a one-standard-deviation increase in the Z-score of each index and hypertension prevalence or blood pressure levels. Discriminatory power was compared using the area under the receiver operating characteristic curve (AUC) overall and within age groups.

Results: Per standard deviation increase, WC, BMI, WHtR, ABSI, and BRI were associated with a 61% (OR 1.61, 95% CI: 1.58–1.64), 61% (1.61, 1.58–1.64), 60% (1.60, 1.57–1.63), 9% (1.09, 1.07–1.11), and 56% (1.56, 1.54–1.59) higher hypertension risk, respectively. WHtR and BRI showed the highest and identical AUC (both 0.676), followed by WC (0.653). ABSI had the lowest AUC (0.612). Discriminatory ability was strongest in adults aged 18–35 years, with WC performing best (AUC = 0.763). The associations for all indices significantly weakened with age ( P for interaction < 0.001).

Conclusions: WHtR and BRI demonstrated the strongest overall associations with hypertension, whereas WC was the best indicator in young adults. The performance of anthropometric indices varied by age, suggesting that age-specific considerations may enhance their utility for preliminary hypertension risk screening in practice.

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Cite

BibTeXRIS
BibTeX
@article{lu2026crosssectional,
  title = {{A cross-sectional study on anthropometric indices and hypertension in Chinese adults: comparison of discriminatory power and age-stratified analysis}},
  author = {Shiqin Lu and Nan Chen and Zhuosong Li and Yuanmei Zhang and Wenping Wang and Guo Li and Jinglan Hao and Rui Wang and Yanmei Qi and Zhengyu Qin},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1933929},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1933929/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A cross-sectional study on anthropometric indices and hypertension in Chinese adults: comparison of discriminatory power and age-stratified analysis
AU  - Shiqin Lu
AU  - Nan Chen
AU  - Zhuosong Li
AU  - Yuanmei Zhang
AU  - Wenping Wang
AU  - Guo Li
AU  - Jinglan Hao
AU  - Rui Wang
AU  - Yanmei Qi
AU  - Zhengyu Qin
PY  - 2026
DA  - 2026/10/15
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1933929
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1933929/full
AB  - Background: Hypertension imposes a heavy public health burden in China. Simple anthropometric indicators help screen hypertension risk, yet the optimal index differs by age. This study compares five adiposity indices including WC, BMI, WHtR, ABSI, and BRI and their age-specific discriminatory ability among Chinese adults.  Materials and methods: In this cross-sectional analysis of 104,248 adults from a health check-up cohort in Southwest China, hypertension was defined as blood pressure ≥140/90 mmHg, a self-reported diagnosis, or current antihypertensive medication use. Multivariable logistic and linear regression models were employed to examine the associations between a one-standard-deviation increase in the Z-score of each index and hypertension prevalence or blood pressure levels. Discriminatory power was compared using the area under the receiver operating characteristic curve (AUC) overall and within age groups.  Results: Per standard deviation increase, WC, BMI, WHtR, ABSI, and BRI were associated with a 61% (OR 1.61, 95% CI: 1.58–1.64), 61% (1.61, 1.58–1.64), 60% (1.60, 1.57–1.63), 9% (1.09, 1.07–1.11), and 56% (1.56, 1.54–1.59) higher hypertension risk, respectively. WHtR and BRI showed the highest and identical AUC (both 0.676), followed by WC (0.653). ABSI had the lowest AUC (0.612). Discriminatory ability was strongest in adults aged 18–35 years, with WC performing best (AUC = 0.763). The associations for all indices significantly weakened with age ( P for interaction < 0.001).  Conclusions: WHtR and BRI demonstrated the strongest overall associations with hypertension, whereas WC was the best indicator in young adults. The performance of anthropometric indices varied by age, suggesting that age-specific considerations may enhance their utility for preliminary hypertension risk screening in practice.
SN  - 2296-2565
ER  -