Abstract
BackgroundThe metabolic syndrome (MetS) has shown strong associations with the hypertriglyceridemic waist (HW) phenotype. The best anthropometric indicator of MetS remains controversial. Furthermore, no studies have investigated alternative indices that could replace waist circumference in the HW phenotype. The objectives of this study were to find the best indicator of MetS among anthropometric indices and to examine the predictive power of phenotypes consisting of triglyceride levels with anthropometric indices.MethodsA total of 12,025 subjects participated in this retrospective cross-sectional study. All subjects were recruited between November 2016 and August 2007 from hospitals in 28 urban and rural regions in South Korea. The data analyzed in this study were obtained from the Korean Health and Genome Epidemiology Study database and the Korea Institute of Oriental Medicine.ResultsThe proportion of patients with MetS ranged from 9 to 57% according to age and gender groups. Waist circumference (WC) was best indicator of MetS in men of all age groups. However, in women aged 40–49 years, the waist-to-height ratio (WHtR) was the best indicator of MetS. Rib circumference and chest circumference were the strongest indicators in women aged 50–59 years and 70–79 years, respectively. The combination of WC and triglyceride (TG) was the best indicator of MetS in men and women overall. However, interestingly, the best indicator was TG + WHtR in women aged 40–49 years and TG + forehead-to-waist ratio in women aged 70–79 years.ConclusionsThe best indicator of MetS in terms of individual anthropometric indices and the various phenotypes combining a single anthropometric index with TG may differ subtly according to age group in women, but not in men. Our findings provide insight into a simple and inexpensive method that could be used to identify MetS in initial health screening efforts in epidemiology and public health.
Highlights
The metabolic syndrome (MetS) has shown strong associations with the hypertriglyceridemic waist (HW) phenotype
To compare the predictive power of individual variables and the various phenotypes consisting of individual anthropometric indices and TG, we considered the main criterion as the area under the receiver operating characteristic curve (AUC) using 10-fold cross-validation to validate the model; the Area under the receiver operating characteristic curve (AUC) value was selected because it is typically used to evaluate the predictive power of indicators and classifications in medicine and biology research
The proportion of MetS was much lower in middle-aged women than in men of the same age, but the proportion of MetS was Association of MetS with individual anthropometric indices Tables 1, 2, 3, 4 and 5 list the associations between MetS and anthropometric indices and the power of the individual indices and the combinations of TG and these indices to identify MetS according to each age group of men and women
Summary
The metabolic syndrome (MetS) has shown strong associations with the hypertriglyceridemic waist (HW) phenotype. Many studies have assessed the associations between MetS and anthropometric indices, the index that best predicts MetS remains controversial, despite the fact that waist circumference (WaistC) is one of the five components of MetS. The HW phenotype has been associated with low education level, age, and a sedentary job [14] This phenotype generally consists of triglyceride (TG) and WaistC and is diagnosed when values of TG and WaistC exceed a specific threshold. Many studies to date have suggested the importance of the HW phenotype in diagnosing MetS or have reported an association between HW and MetS [14, 15, 18,19,20,21,22]
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