Urban and rural differences in the relationship between altitude and central adiposity in the peruvian population

Introduction: The relationship between geographic altitude and central adiposity has been little explored, especially when considering differences between urban and rural areas in altitudinally diverse countries such as Peru. Objective: To determine the variation in central adiposity among Peruvian adults based on geographical altitude and area of residence (urban or rural). Material and Methods: Analytical cross-sectional study using secondary data from 20, 489 adults from urban and rural areas. Variables included: residential altitude, waist-to-hip ratio, body mass index, height, and weight. Multiple linear regression, Student’s t-test, and decision trees using Chi-squared Automatic Interaction Detection were applied. Results: In rural populations, the regression equation was: 6626.45 + (-2143.69 * waist-to-hip ratio) + (-1442.23 * height) + (-20.46 * weight). In urban populations, the equation was: 1071.439 + (719.152 * waist-tohip ratio) + (586.837 * height) + (-20.328 * weight). The decision tree showed that living below 1 500 meters was mainly associated with a body mass index >30.296; between 1500 and 2 999 meters: body mass index between 22.957 and 24.692; at ≥3 000 meters: waist-to-hip ratio ≤0.470 with body mass index ≤22.957. In urban areas below 1 500 meters: waisttohip ratio ≤0.638 with body mass index between 30.599 and 32.990. Between 1 500 and 2 999 meters: waist-to-hip ratio ≤0.573 with body mass index between 24.651 and 26.670. At ≥3 000 meters: body mass index ≤24.651 Conclusions: Geographic altitude of residence is associated with variations in central adiposity among Peruvian adults, with higher obesity levels in low-altitude areas and a predominance of normal weight at higher altitudes in both rural and urban settings.