Abstract
Background: Planning for obesity prevention is an important global health priority. Our aim in this study was to find the optimal cut-off points of waist circumference (WC), waist- to- hipratio (WHR) and waist- to- height ratio (WHtR), as three anthropometric indices, for prediction of overweight and obesity. We also aimed to compare the predictive ability of these indices to introduce the best choice. Methods: In this cross-sectional study, a total of 500 subjects were investigated. Anthropometric indicators were measured using a standard protocol. We considered body mass index (BMI) as the simple and most commonly used index for measuring general obesity as the comparison indicator in the present study to assess the diagnostic value for other reported obesity indices.We also performed receiver operating characteristic (ROC) curve analysis to define the optimal cut-off points of the anthropometric indicators and the best indices for overweight and obesity. Results: The proposed optimal cut-offs for WC, WHtR, and WHR were 84 cm, 0.48 and 0.78 for women and 98 cm, 0.56 and 0.87 for men, respectively. The area under the ROC curve ofWHtR (women: AUC=0.97, 95% CI: 0.96-0.99 vs. men: AUC=0.97, 95%CI: 0.96-0.99) and WC(women: AUC=0.97, 95% CI, 0.95-0.99 vs. men: AUC=0.98, 95% CI: 0.97-0.99) were greater than WHR (women: AUC=0.79, 95% CI =0.74-0.85 vs. men: AUC=0.84, 95% CI=0.79-0.88). Conclusion: This study demonstrated that the WC and WHtR indicators are stronger indicators compared to the others. However, further studies using desirable and also local cutoffs against more accurate techniques for body fat measurement such as computerized tumor (CT) scans and dual-energy x-ray absorptiometry (DEXA) are required.
Highlights
The high prevalence of overweight and obesity represents the main challenge for prevention of chronic diseases.[1,2,3,4,5] The first step in community health planning is screening and identifying overweight and obesity via easy and precise methods.[6]
Obesity, which is defined to an excess of body fat, can be detected accurately using dual-energy x-ray absorptiometry (DEXA) and magnetic resonance imaging (MRI) techniques.[7]
By considering the prevalence of obesity, a sensitivity of 96% and a specificity of 60% for waist circumference (WC), the best indicators of abdominal obesity, a confidence interval (CI) of 95% and a power of 90%, the minimum sample size was calculated to be at least 455 subjects
Summary
The high prevalence of overweight and obesity represents the main challenge for prevention of chronic diseases.[1,2,3,4,5] The first step in community health planning is screening and identifying overweight and obesity via easy and precise methods.[6]. ROC curves were applied to evaluate the WC and WHR values, as screening measures beside BMI (as the reference test).[14]. Our aim in this study was to find the optimal cut-off points of waist circumference (WC), waist- to- hip ratio (WHR) and waist- to- height ratio (WHtR), as three anthropometric indices, for prediction of overweight and obesity. We considered body mass index (BMI) as the simple and most commonly used index for measuring general obesity as the comparison indicator in the present study to assess the diagnostic value for other reported obesity indices. We performed receiver operating characteristic (ROC) curve analysis to define the optimal cut-off points of the anthropometric indicators and the best indices for overweight and obesity. Further studies using desirable and local cutoffs against more accurate techniques for body fat measurement such as computerized tumor (CT) scans and dual-energy x-ray absorptiometry (DEXA) are required
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