Abstract
BackgroundPeople of different racial and ethnic backgrounds have a distinct pattern of central fat deposition, thus making it necessary to devise a race based approach for the diagnosis and evaluation of abdominal obesity (AO). This is the first study to determine the optimal waist circumference (WC) cutoff values for definition of AO in an ethnic Kyrgyz population.Methods323 persons of Kyrgyz ethnicity (183 women and 140 men), with a mean age of 51.8 ± 9.5 years old were included in the study. Measurement of blood pressure (BP), anthropometric data (including body mass index calculation and WC measurement), fasting blood sugar, serum lipid parameters and insulin were performed in all examined individuals. Insulin resistance (IR) was considered as HOMA index (insulin × fasting glucose/22.5) ≥ 2.77. Sensitivity and specificity for the presence of IR or two other criteria of MS (according to the international classification, 2009) were calculated by using receiver operating characteristic (ROC) curves for men and women separately.ResultsThe optimal sensitivity and specificity obtained from the ROC curves for IR were 88 cm in women (sensitivity of 0.85, 95%CI (0.72-0.93), specificity of 0.58, 95%CI (0.49-0.66)) and 94 cm for men (sensitivity of 0.8, 95% CI (0.65-0.91), specificity of 0.61, 95% CI (0.51-0.71)). The data from the ROC curve for any two other MS criteria confirmed the results and the WC 88 cm in women (sensitivity of 0.82, 95% CI (0.72-0.9), specificity of 0.72, 95% CI (0.62-0.8)) and 94 cm in men (sensitivity of 0.74, 95% CI (0.62-0.84), specificity of 0.73, 95% CI (0.61-0.83)) were corresponded to the optimal sensitivity and specificity.ConclusionWC ≥ 88 cm and ≥ 94 cm should be used as a criterion for the diagnosis of AO for Kyrgyz women and men respectively based on these results.
Highlights
People of different racial and ethnic backgrounds have a distinct pattern of central fat deposition, making it necessary to devise a race based approach for the diagnosis and evaluation of abdominal obesity (AO)
Women were subdivided based on the waist circumference (WC) values into subgroups of < 80 cm, 80-87 cm, and ≥88 cm; and men were subdivided into these subgroups < 90 cm, 90- 93 cm, 94-101 cm, ≥102 cm
Each subgroup was analyzed for the presence of insulin resistance (IR), blood insulin concentration, the Homeostasis model of assessment (HOMA) index and the Odds ratio (OR) of having IR
Summary
People of different racial and ethnic backgrounds have a distinct pattern of central fat deposition, making it necessary to devise a race based approach for the diagnosis and evaluation of abdominal obesity (AO). This is the first study to determine the optimal waist circumference (WC) cutoff values for definition of AO in an ethnic Kyrgyz population. Since ATP III clinical criteria are best suitable for North American population, and the fact that people of Asian origin have higher abdominal fat with the same body mass index (BMI) as well as a greater risk for the new onset type 2 DM with the same BMI values and this approach may underestimate metabolic risk among Asians [7]. Park and colleagues have demonstrated that Asians with BMI < 27 kg/m2 have higher predictive power of epicardial fat for the presence of MS and coronary artery disease, which may indirectly support the notion of distinct pattern of adiposity among Asians [9]
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