Abstract
Despite several papers having been published on the association between adiposity and the risk of metabolic syndrome (MetS), it is still difficult to determine unambiguously which of the indices of nutritional status is the best to identify MetS. The aim of this study was to analyze the ability of six anthropometric indices to identify MetS in the Polish population. The highest odds ratios for the occurrence of MetS, according to International Diabetes Federation (IDF), were noted for the following indices: waist-to-height ratio (WHtR, OR = 24.87) and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE, OR = 17.47) in men and WHtR (OR = 25.61) and body roundness index (BRI, OR = 16.44) in women. The highest odds ratios for the modified definition of MetS (without waist circumference) were found for the following indices: WHtR (OR = 7.32), BRI (OR = 6.57), and CUN-BAE (OR = 6.12) in women and CUN-BAE (OR = 5.83), WHtR (OR = 5.70), and body mass index (BMI, OR = 5.65) in men (p < 0.001 for all). According to the Receiver Operating Characteristic (ROC) analyses conducted for the identification of MetS, defined in accordance with IDF, the largest areas under the curve (AUCs) in men were observed for WHtR and CUN-BAE indices, whereas in women, they were observed for WHtR and BRI. In the analysis carried out for the identification of MetS (according to modified definition, without waist circumference), the AUCs were larger for WHtR and BRI in women, while in men, they were larger for CUN-BAE, BMI, and WHtR. BMI was also characterized by a relatively strong discriminatory power in identifying individuals with MetS. An optimal cut-off point for MetS, in accordance with the conventional definition, for both sexes was the value of BMI = 27.2 kg/m2. The weakest predictor of the syndrome was the ABSI (a body shape index) indicator. The most useful anthropometric indicator for the identification of MetS, both in men and in women in the Polish population, was WHtR. The optimal cut-off points for WHtR equaled 0.56 in men and 0.54 in women.
Highlights
Obesity is a significant risk factor for the development of several diseases, such as type 2 diabetes [1], metabolic syndrome (MetS) [2,3], cardiovascular diseases [4,5], numerous tumors [6,7,8], and musculoskeletal disorders [5], as well as a cause of high mortality [8,9]
In the analysis carried out for the identification of MetS, the area under the curve (AUC) were larger for Waist-to-height ratio (WHtR) and body roundness index (BRI) in women, while in men, they were larger for Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), body mass index (BMI), and WHtR
Men were characterized by higher values of all anthropometric features and indicators of nutritional status than women (Table 1)
Summary
Obesity is a significant risk factor for the development of several diseases, such as type 2 diabetes [1], metabolic syndrome (MetS) [2,3], cardiovascular diseases [4,5], numerous tumors [6,7,8], and musculoskeletal disorders [5], as well as a cause of high mortality [8,9]. Limitations of BMI are its low accuracy in the assessment of adipose tissue and the fact that it does not allow for sex dimorphism and ethnic differences in adiposity, adipose tissue distribution, and age-related body composition [12,13,14]. Despite these limitations, the level of obesity determined on the basis of BMI is one of the main criteria for the application of pharmacological and surgical intervention [15]. A high ABSI value indicates the waist circumference is higher than expected for a given height and mass and is related to a more central concentration of body volume
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