Abstract
Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases and certain cancers. Early detection of abdominal obesity followed by appropriate interventions will prevent associated diseases. The objective was to determine optimal waist circumference (WC) cut-off points predictive of at least one other component of metabolic syndrome in Benin adults. This longitudinal and observational study included at the baseline 541 apparently healthy subjects aged 25 - 60 years randomly selected in the largest city of Cotonou (n = 200), the smaller-size city of Ouidah (n = 171) and rural surroundings of Ouidah (n = 170) in Benin. Components of the metabolic syndrome considered along with abdominal obesity were high blood pressure, high fasting glycaemia, low HDL-cholesterol and high triglycerides as defined by the Joint Interim Statement. After the baseline survey, the subjects were followed-up for four years. Complete data at baseline and four years later were available in 416 subjects. The receiver operating characteristic (ROC) curve for waist circumference to predict at least one other component of the metabolic syndrome was plotted and the Youden index was used to define the optimal cut-offs of WC. At the baseline of the study, the optimal WC cut-off point to predict the presence of at least one other component of the metabolic syndrome was 80 cm for men (sensitivity = 0.62, specificity = 0.65); the area under the ROC curve was 0.67 (IC 95%: 0.61-0.74). In women, the optimal WC cut-off point was 90 cm (sensitivity = 0.54, specificity = 0.80), and the area under the ROC curve was 0.68 (IC 95%: 0.62-0.75). These optimal cut-offs were similar four years later. Optimum WC cut-off points for both men and women in Benin differ from those currently recommended for sub-Saharan Africans. Therefore, waist circumference cut-off points for abdominal obesity need to be reconsidered for these populations.
Highlights
Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases (CVD) and certain cancers [1], which are the leading causes of death worldwide [2] [3]
Motala et al [23] recently determined in a rural black population of South Africa, optimal waist circumference (WC) cut-offs to predict two other components of metabolic syndrome (MS) that were different from those currently recommended for sub-Saharan Africans
We hypothesize that the optimal WC cut-offs predictive of at least one component of SM in Benin are different from those currently recommended for sub-Saharan Africans
Summary
Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases (CVD) and certain cancers [1], which are the leading causes of death worldwide [2] [3]. The increasing incidence of chronic diseases associated with obesity affects mainly developing countries (DCs) [4]. Metabolic syndrome points out numerous vascular risk factors clustering together, due to a common mechanistic substratum, visceral obesity and insulin resistance [9]. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and abdominal obesity. Several studies reported that people with MS have an increased risk to develop diseases such as diabetes, and CVD [10] [11]
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