Introduction: The mortality of circulatory diseases of the German
population varies considerably across regions. The comparison of the regional
distributions of cardiovascular risk factors can provide clues to the reasons
for cardiovascular mortality differences. The aim of this study was to determine
whether indirect measures of fat distribution within subgroups of comparable
body mass indices (BMIs) differ by region in Germany.
Methods: We included six German population-based epidemiological
studies conducted between 1997 and 2006 that included a detailed assessment of
anthropometric measures including overall 15 215 people aged 45–74
years. We calculated mean values of BMI, waist circumference (WC), hip
circumference (HC), and waist-to-hip ratio (WHR). We estimated mean regional
differences of WC, HC, and WHR within narrow ranges of BMI.
Results: BMI distributions across the study populations were very
similar. However, body fat distributions as measured by WC within subgroups of
similar BMIs differed considerably across regions. For example, among people
with a BMI of 24.0–25.9, estimated WCs were on average 3.4 and
6.7 cm higher among men and women in Saxony-Anhalt than among men
and women in Bavaria, respectively.
Conclusion: We provide evidence that the BMI distributions across
six population-based surveys in Germany are very similar and that body fat
distributions among people with comparable BMIs show relevant regional
differences. Our observed WC differences might contribute to regional
cardiovascular disease risk differences in Germany. Our findings may trigger
further similar analyses across European populations to explain large area
variations of cardiovascular disease burden.
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