Optimal Waist Circumference Cutoff Values Research Articles

Comparison of waist circumference and waist-to-height ratio as predictors of clustering of cardiovascular risk factors among middle-aged people in rural Khanh Hoa, Vietnam.

Given the population-level variation in stature, a universal cut-off for waist circumference (WC) may not be appropriate for some populations. We compared the performance of WC and waist-to-height ratio (WHtR) to detect the clustering of cardiovascular disease (CVD) risk factors in rural Vietnam. We obtained data from a baseline survey of the Khanh Hoa Cardiovascular Study comprising 2942 middle-aged residents (40-60 years). We used areas under the receiver operating characteristics curve (AUROC), net reclassification index (NRI), and integrated discrimination improvement (IDI) to compare the performance of WC and WHtR in predicting CVD risk clustering (≥2 of the following risk factors: hypertension, diabetes, dyslipidemia, and elevated C-reactive protein). The optimal cut-off values for WC were 81.8 and 80.7 cm for men and women, respectively. Regarding the clustering of CVD risk factors, the AUROC (95% CI) of WC and WHtR were 0.707 (0.676 to 0.739) and 0.719 (0.689 to 0.749) in men, and 0.682 (0.654 to 0.709) and 0.690 (0.663 to 0.717) in women, respectively. Compared with WC, WHtR had a better NRI (0.229; 0.102-0.344) and IDI (0.012; 0.004-0.020) in men and a better NRI (0.154; 0.050-0.257) in women. The optimal WC cut-off for Vietnamese men was approximately 10 cm below the recommended Asian cut-off. WHtR might perform slightly better in predicting the clustering of CVD risk factors among the rural population in Vietnam.

The prevalence of obesity and relationship between obesity indicators and chronic diseases in Northern Shaanxi, China.

Obesity not only affects human health but also is an important risk factor for a variety of chronic diseases. Therefore, it is particularly important to analyse the epidemic trend of obesity and actively carry out the prevention and control of obesity in the population. A total of 4565 adults were selected by multi-stage stratified random sampling in Shenmu, Shaanxi Province, China. Univariate analysis was used to explore the epidemic characteristics of obesity in this region. Multivariate logistic regression was used to analyse the relationship between obesity and chronic diseases. Finally, the prediction efficiency of different obesity indexes was analysed by drawing receiver operator characteristic curves (ROC). All statistical analysis was completed by SPSS 26.0 software. The prevalence rates of overweight, obesity, and central obesity were 39.9%, 18.2%, and 48.0%, respectively. After adjusting for other confounding factors, multivariate logistic regression analysis showed that overweight and obesity were risk factors for hypertension, dyslipidaemia, and hyperuricaemia. Central obesity is a risk factor for dyslipidaemia and hyperuricaemia. High level of waist-to-height ratio (WHtR) was a risk factor for dyslipidaemia and hyperuricaemia (p < 0.05). Obesity-related indicators: body mass index (BMI), waist circumference (WC), and WHtR, are strongly correlated with the increased risk of chronic diseases in northern Shaanxi, China. The optimal BMI cut-off values for predicting hypertension, dyslipidaemia, and hyperuricaemia were 24.27, 24.04, and 25.54, respectively. The optimal WC cut-off values for predicting dyslipidaemia and hyperuricaemia were 84.5 and 90.5, and WHtR cut-off values were 0.52 and 0.54, respectively. The problem of overweight, obesity, and central obesity in adults is serious in northern Shaanxi, China. Obesity of all types will increase the risk of chronic diseases. Therefore, a variety of preventive and therapeutic measures should be adopted to curb obesity and reduce the incidence of related chronic diseases.

Simple anthropometric measures to predict visceral adipose tissue area in middle-aged Indonesian men.

The diagnosing of central obesity requires ethnic-specific cut-offs of waist circumference (WC) and body mass index (BMI). This study aims to develop formulas to predict visceral adipose tissue (VAT) area based on WC and BMI to determine the cut-off points of central obesity in Indonesia. We conducted a cross-sectional study among 32 middle-aged Indonesian men. VAT area was measured using an abdominal CT scan, whereas WC and BMI were assessed through anthropometric measurements. Linear regression analysis was performed to define the formulas to predict VAT area using WC and BMI. Next, the optimal cut-off values of WC and BMI were determined using ROC curve analysis. Strong positive correlations were found between WC and VAT as well as BMI and VAT (r = 0.78; r = 0.67, p <0.001). The formula to predict VAT area from WC was -182.65 + (3.35 × WC), whereas the formula to predict VAT area from BMI was -57.22 + (6.95 × BMI). These formulas predicted WC of 88.5 cm and BMI of 23.9 kg/m2 as the optimal cut-off values for central obesity in middle-aged Indonesian men.

Association of waist circumference with haemoglobin A1c and its optimal cutoff for identifying prediabetes and diabetes risk in the Chinese population

Haemoglobin A1c (HbA1c) is a marker of glycaemic control in type 2 diabetes mellitus (T2DM). Increased waist circumference (WC) is known to be associated with T2DM. Therefore, we investigated the relationship of WC with HbA1c and explored its optimal cutoff for identifying prediabetes and diabetes risk. This study included 2339 participants between 18 and 84 years of age [mean (SD) age, 43.5 (11.9) years] with valid data on WC, HbA1c and related variables in the Shenzhen–Hong Kong United Network on Cardiovascular Disease study. Participants on anti-diabetic medications were excluded. Multiple linear regression was used to investigate the relationship between HbA1c and WC. Cutoff values of WC indicating an HbA1c level of 5.7% and 6.5% were also assessed using optimal binning. There was a significant linear relationship between WC and HbA1c in the overall population (B = 0.261, P < 0.001), men (B = 0.206, P < 0.001) and women (B = 0.311, P < 0.001). After adjustment for smoking, alcohol consumption, physical activity, hypertension, hypercholesterolaemia and age, the association remained significant in the overall population (B = 0.201, P < 0.001), men (B = 0.186, P < 0.001) and women (B = 0.182, P < 0.001). The optimal cutoff values of WC indicating an HbA1c level of 5.7% and 6.5% was 83 cm (entropy = 0.943) and 85 cm (entropy = 0.365) in men, and 78 cm (entropy = 0.922) and 86 cm (entropy = 0.256) in women. The linear relationship between WC and HbA1c in this study suggests that addressing central obesity issue is beneficial to people with T2DM or at risk of T2DM. WC cutoff values of 85 cm for men and 86 cm for women are appropriate for recommendation to undergo diabetes screening.

Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study

Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study

Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study.

Objective:Waist circumference (WC) value reflects abdominal adiposity, but the amount abdominal fat that is associated to cardiometabolic risk factors varies among ethnicities. Determination of metabolic abnormalities has not undergone a WC adaptation process in Venezuela. The aim of the study was (1) to determine the optimal WC cutoff value associated with ≥2 cardiometabolic alterations and (2) incorporating this new WC cutoff, to determine the prevalence of abdominal obesity and cardiometabolic risk factors related in Venezuela.Methods:The study was national population-based, cross-sectional, and randomized sample, from 2014 to 2017. To assess performance of WC for identifying cardiometabolic alterations, receiver operating characteristics curves, area under the curve (AUC), sensitivity, specificity, and positive likelihood ratios were calculated.Results:Three thousand three hundred eighty-seven adults were evaluated with mean age of 41.2 ± 15.8 years. Using the best tradeoff between sensitivity and specificity, WC cutoffs of 90 cm in men (sensitivity = 72.4% and specificity = 66.1%) and 86 cm in women (sensitivity = 76.2% and specificity = 61.4%) were optimal for aggregation of ≥2 cardiometabolic alterations. AUC was 0.75 in men and 0.73 in women using these new cutoffs. Prevalence of abdominal obesity and metabolic syndrome was 59.6% (95 CI; 57.5-61.7) and 47.6% (95 CI; 45.2-50.0), respectively. Cardiometabolic risk factors were associated with being men, higher age, adiposity, and living in northern or western regions.Conclusion:The optimal WC values associated with cardiometabolic alterations were 90 cm in men and 86 cm in women. More than half of the Venezuelan population had abdominal obesity incorporating this new WC cutoff.

Predicting value of five anthropometric measures in metabolic syndrome among Jiangsu Province, China

BackgroundMetabolic syndrome (MetS), a condition of metabolic disorders, is now causing large disease burden around the world. This study aimed to update the prevalence of MetS in Jiangsu Province of China and evaluate the predicting value of five anthropometric measures including waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), a body shape index (ABSI) and body roundness index (BRI) in MetS.Methods8040 participants from 12 survey sites were enrolled into this cross-sectional study by multi-stage stratified cluster random sampling method from 2014 nutrition and diet investigation project in Jiangsu Province. The transformation of sex-specific z-score made the comparison meaningful when conducting the logistic analysis between anthropometric indices and MetS. The abilities of anthropometric indices to predict MetS were evaluated by the receiver operating characteristic curve (ROC). Delong test was applied to compare area under different ROC curves.ResultsThe prevalence of MetS in Jiangsu Province was 35.2% and the standardized prevalence was 34.8%. WC, BMI, WHtR, ABSI and BRI z-scores were positively related to MetS and its components. WC, WHtR and BRI z-score had stronger associations with MetS than BMI and ABSI in both male and female population. WC, WHtR and BRI had larger area under ROC curve than BMI and ABSI in male and female. WC in men had the largest area under the ROC curve, significantly higher than the other four measures of BMI, WHtR, ABSI and BRI (Z value = 9.08, 2.88, 16.73, 2.75 respectively). Among women, WC, WHtR and BRI had larger area under the ROC curve than BMI and ABSI, but the area under the WC, WHtR and BRI curve were not significantly different after the pairwise comparison by the Delong test. The optimal cut-off values of WC, WHtR and BRI for predicting MetS was 85.25 cm, 0.52 and 3.61 in male, 80.05 cm, 0.51 and 3.83 in female.ConclusionMetS has become one of the major chronic diseases in Jiangsu Province. WC was better than other four indices in predicting MetS among male population in Jiangsu. WC, WHtR and BRI had superior abilities than BMI/ABSI in predicting MetS among female population.

Optimal maternal neck and waist circumference cutoff values for prediction of gestational diabetes mellitus at the first trimester in Turkish population; a prospective cohort study

Aims: To investigate if the maternal neck (NC) and waist (WC) circumferences measured in the first trimester of pregnancy have a predictive value in diagnosing gestational diabetes mellitus (GDM).Materials and methods: In this prospective study NC and WC of pregnant women were measured at 11–14th weeks. GDM was evaluated with a two-step oral glucose tolerance test at 24–28th weeks.Result: A total of 525 women were recruited; 49(9%) developed GDM. NC was positively correlated with WC (r: 0.583, p < .001), BMI (r: 0.533, p < .001), age (r: 0.123, p = .002), parity (r: 0.170, p < .001), and 50 g OGTT levels (r: 0.206, p < .001). Regarding the area under receiver operating characteristic (ROC) curve (AUC) analysis of NC and WC for predicting GDM were 0.585 (95% confidence interval (CI): 0.50–0.66, p = .043), and 0.693 (95%CI: 0.61–0.76, p < .001). The optimal cut off level of maternal NC was >38.5 cm, with 69% sensitivity and 45% specificity, and WC was >84.50 cm with a sensitivity of 78% and a specificity of 54%. Increased WC >84.50 cm (OR: 3.58, 95% CI:1.77–7.27; p < .001) and age >25 (OR: 3.05, 95% CI:1.38–6.72; p = .006) were independent predictors for the development of GDM adjusted for age, gravidity, parity, BMI, and NC.Conclusion: Maternal NC and WC were significantly higher in women with GDM; however, only maternal WC was a significant predictive marker for GDM in low-risk pregnant women.

Optimal waist circumference cutoff values for predicting metabolic syndrome among older adults in Ecuador

AimsTo determine optimal waist circumference cutoff values for predicting metabolic syndrome (MetS) among adults aged 60 years and older in Ecuador. Material and methodsThe National Survey of Health, Wellbeing, and Aging survey was used to describe the prevalence of MetS according to standard definitions. Receiver operating characteristics (ROC) curve analyses and the Younden index J (YI) were performed to examine optimal waist circumference cutoff values for predicting MetS. Moreover, the prevalence of MetS according to country-specific waist circumference cutoff values was compared with those using standard definitions. ResultsAmong 2306 participants with a mean age of 70.6 years, the optimal waist circumference cutoff value for predicting MetS was 90.7 cm in women with a sensitivity of 66.1%, specificity of 65.6% and YI of 0.31. In men, a waist circumference of 91.2 cm with a sensitivity of 73.2%, specificity of 62.8%, and YI of 0.36 was the optimal cutoff point for predicting MetS. In general, applying country-specific cutoff values decreased the prevalence of MetS among older Ecuadorian women. In men, except with the ATP III definition, similar MetS prevalence rates were seen whether the country-specific or standard waist circumference cutoff values were applied. ConclusionsThe optimal waist circumference cutoff values for predicting metabolic syndrome among older Ecuadorians adults were 90.7 cm for women and 91.2 cm for men. Moreover, current standard definitions of abdominal obesity may overestimate the prevalence of MetS, particularly in Latin American women.

Is waist circumference more strongly associated with metabolic risk factors than waist-to-height ratio in Asians?

Differential distribution of fats can vary among ethnic groups and thus have varying effects on metabolic risk. Measuring metabolic risk of individuals using simple anthropometric measurements is essential to replace current invasive methods of obtaining blood samples. Waist-to-height ratio (WHtR) has been advocated as the best simple anthropometric measurement, but, because of the high visceral fat of Asians, there has been speculation as to the possibility of using only waist circumference (WC) to measure metabolic risk. The aim of this study was to compare the performance of WC and WHtR in terms of their association with measures of obesity and metabolic risk factors (e.g., homeostasis model assessment for insulin resistance, low-density lipoprotein, triacylglycerol, and ratio of triacylglycerol to high-density lipoprotein) and to obtain an optimal cutoff value for one anthropometric measurement. The study was performed on healthy Asian Chinese (N = 527) men (n = 209) and women (n = 318) who participated in a cross-sectional study conducted at the Clinical Nutrition Research Centre located in Singapore. Association of WC and WHtR with metabolic risk factors was obtained using Spearman's rank correlation coefficient. Optimal cutoff value was obtained using receiver operating characteristic curve. WC and WHtR performed equally well in both sexes in terms of their strength of association between metabolic risk factors. Receiver operating characteristic curve analysis showed that 73.5 cm (in women) and 82.5 cm (in men) were the optimal WC cutoff values to identify insulin resistance. It is suggested that WC is a simpler anthropometric measurement that has strong association with an individual's metabolic risk level.

Cut-Off Values for Visceral Fat Area Identifying Korean Adults at Risk for Metabolic Syndrome.

BackgroundCut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individuals at risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly for large populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare the ability of VFA and WC to predict the presence of ≥2 metabolic risk factors.MethodsWe included 36,783 subjects aged 19–79 years undergoing abdominal fat CT during regular health checkups between January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the International Diabetes Federation criteria. Receiver operating characteristic curve analyses were used to determine the appropriate VFA and WC cut-off values for MetS.ResultsVFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). The optimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age, particularly among women.ConclusionThis large population study proposed the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WC may be considered.

Sensitivity and specificity of waist circumference as a single screening tool for assessment of overweight and obesity

Background: Generalised and central obesity are established risk factors for metabolic syndrome and cardiovascular diseases. Easy assessment of overweight or obesity is the need of the hour from public health perspective. Waist circumference (WC) can be a simple screening tool for identifying overweight individuals since measuring WC is simple, inexpensive, less time consuming, convenient for self-monitoring and needs no complicated calculation as BMI.Methods: A community based cross-sectional study was conducted in January-February 2017 among 338 adults, in a village of Singur Block, West Bengal. Height, weight and WC were measured for each subject. Receiver Operating Characteristic (ROC) curve analysis was used to estimate the cut-off values of WC.Results: The sensitivity and specificity of WC ≥90 centimeters for men for identifying overweight (BMI ≥25) were 78.8% and 75.6% respectively, whereas those of WC ≥80 cm for women were 80.3% and 44% respectively. ROC curve analysis revealed good diagnostic accuracy at 88.5 cm for WC cut-off for men (area under curve (AUC) 0.854, sensitivity 86.5%, specificity 67.6%) and fair accuracy (AUC 0.744, sensitivity 80.3%, specificity 44%) for WC cut-off for 80 cm for women.Conclusions: This study shows, WC can be used for screening of overweight individual infield practice as measuring tape is inexpensive and easy-to-carry compared to a weighing scale. More research may be done on larger sample size to establish an optimal WC cut-off value for Indian population.

Anthropometric cutoff values for predicting metabolic syndrome in a Saudi community: from the SAUDI-DM study.

BACKGROUNDThe prevalence of metabolic syndrome varies widely by ethnicity and by the criteria used in its definition.OBJECTIVETo identify the optimal cutoff values for waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) for identifying metabolic syndrome among the Saudi population.DESIGNNationwide household cross-sectional population-based survey.SETTINGThirteen health sectors in Saudi Arabia.SUBJECTS AND METHODSWe used data for subjects in the Saudi Abnormal Glucose Metabolism and Diabetes Impact Study (SAUDI-DM), which was conducted from 2007 to 2009. Using International Diabetes Federation (IDF) criteria, metabolic syndrome and its different components were assessed using anthropometric measurements, blood pressure, fasting plasma glucose, triglycerides and HDL cholesterol. Receiver operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cutoff values of WC, WHR, and BMI. The Youden index was used to calculate the optimal cutoff value for each anthropometric measurement.MAIN OUTCOME MEASURE(S)Optimal cutoff value for WC, WHR, and BMI for identifying the risk of metabolic syndrome.RESULTSThe prevalence of two or more risk factors for metabolic syndrome was observed in 43.42% of the total cohort of 12 126 study participants ≥18 years of age. The presence of two or more risk factors were significantly higher among men (46.81%) than women (40.53%) (P<.001). The optimal cutoff values for WC, WHR, and BMI were 92 cm, 0.89, and 25 kg/m2 for men and 87 cm, 0.81 and 28 kg/m2 for women for identifying the risk of metabolic syndrome. The prevalence of elevated triglycerides, blood pressure, and fasting plasma glucose significantly increased with age for both genders.CONCLUSIONSThe proposed WC cutoff values were better than WHR and BMI in predicting metabolic syndrome and could be used for screening people at high risk for metabolic syndrome in the Saudi population.LIMITATIONSNo direct measure of body fatness and fat distribution, cross-sectional design.

Proposed cut-off values of the waist circumference for metabolic syndrome based on visceral fat volume in a Japanese population.

Aim/IntroductionWaist circumference (WC) is the most important parameter for diagnosis of metabolic syndrome. The present study was carried out to obtain optimal WC cut‐off values for diagnosis of metabolic syndrome in a Japanese population based on the measurement of total intra‐abdominal visceral fat volume (VFV), which could be expected to reflect visceral obesity more precisely than visceral fat area.Materials and MethodsA total of 405 Japanese persons undergoing health screening were investigated. visceral fat volume was calculated from the data in 700–800 computed tomography slices from the top of the liver to the floor of the pelvic cavity. Then, receiver operating characteristic analysis was used to determine the cut‐off value of the VFV/height ratio. Subsequently, the corresponding WC value was obtained by linear regression analysis.ResultsThe cut‐off value of the VFV/height ratio was 2,317 cm3/m in men and 1,425 cm3/m in women. The sensitivity and specificity of the ratio were 52.9 and 86.4% in men vs 63.4 and 82.2% in women, respectively. The corresponding cut‐off value of WC was 86.0 cm in men and 80.9 cm in women.ConclusionsThe proposed cut‐off values of WC for metabolic syndrome are 85 cm in Japanese men and 80 cm in Japanese women.

Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes

BackgroundVisceral obesity is the most powerful contributor to the development of metabolic syndrome (MetS) and cardiovascular diseases. In light of visceral obesity, however, there is a paucity of data on the appropriate cutoff point of waist circumference (WC) in subjects with type 2 diabetes. The aim of this study was to investigate the optimal cutoff value for WC that signals insulin resistance (IR) and visceral obesity in Koreans with type 2 diabetes.MethodsWe evaluated 4,252 patients with type 2 diabetes (male 2,220, female 2,032, mean age 57.24 years) who visited our clinic between January 2003 and June 2009. WC was measured at the midpoint between the lower rib and the iliac crest, and insulin sensitivity was assessed by the rate constant of plasma glucose disappearance (Kitt %/min) using an insulin tolerance test. Visceral fat thickness was measured using ultrasonography. Statistical analysis was performed using receiver operating characteristic curve.ResultsThe optimal cutoff points for WC for identifying the presence of IR and visceral obesity, as well as two or more metabolic components, were 87 cm for men and 81 cm for women. Moreover, these cutoff points had the highest predictive powers for the presence of visceral obesity. The MetS defined by new criteria correlated with the increased carotid intima-media thickness in female subjects.ConclusionOur results suggest that the optimal cutoff values for WC in Koreans with type 2 diabetes should be reestablished based on IR and visceral obesity.

Optimal Waist Circumference Cut-Off Point for Multiple Risk Factor Aggregation: Results from the Maracaibo City Metabolic Syndrome Prevalence Study

Context and Objective. The purpose of this study was to determine optimal waist circumference (WC) cut-off values for the detection of multiple risk factor aggregation in individuals from Maracaibo, Venezuela.Participants and Methods. A total of 1,902 adult individuals of both genders belonging to MMSPS were included. Complete physical, laboratory, and anthropometric examination were done to evaluate Metabolic Syndrome (MS) components and insulin resistance. ROC curves were plotted for risk factor aggregation in order to assess WC cut-off point. Logistic regression models were constructed to assess risk factors associated with the WC.Results. There were 52.2% females and 47.8% males, with WC of90.7±13.7 cm and98.2±15.9 cm, respectively. ROC curves exhibited a WC cut-off point for women of 90.25 cm (68.4% sensitivity, 65.8% specificity) and 95.15 cm (71.1% sensitivity, 67.4% specificity) for men. HOMA2-IR and high blood pressure were associated with a WC over these cut-off points, as well as 2.5-fold risk increase for multiple risk factor aggregation (OR 2.56; CI 95%: 2.05–3.20;P&lt;0.01).Conclusions. These population-specific WC cut-offs are readily applicable tools for detection of risk factor aggregation. Insulin resistance is closely associated with this definition of abdominal obesity, which may serve as a surrogate for its assessment.

Optimal Waist Circumference Cut-off values for Identifying Metabolic Risk Factors in Middle-aged and Elderly Subjects in Shandong Province of China

ObjectiveTo study the optimal waist circumference (WC) cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China. MethodsA total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome (MetS) was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared. ResultsThe WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men. ConclusionThe appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.

Prevalence of the metabolic syndrome and determination of optimal cut-off values of waist circumference in university employees from Angola.

SummaryBackgroundEstimates of the prevalence of the metabolic syndrome in Africans may be inconsistent due to lack of African-specific cut-off values of waist circumference (WC). This study determined the prevalence of the metabolic syndrome and defined optimal values of WC in Africans.MethodsThis cross-sectional study collected demographic, anthropometric and clinical data of 615 Universitary employees, in Luanda, Angola. The metabolic syndrome was defined using the third report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the Joint Interim Statement (JIS) criteria. Receiver operating characteristics curves were constructed to assess cut-off values of WC.ResultsThe crude prevalence of the metabolic syndrome was higher with the JIS definition (27.8%, age-standardised 14.1%) than with the ATP III definition (17.6%, age-standardised 8.7%). Optimal cut-off values of WC were 87.5 and 80.5 cm in men and women, respectively.ConclusionsThere was a high prevalence of the metabolic syndrome among our African subjects. Our data suggest different WC cut-off values for Africans in relation to other populations.

Optimal waist circumference cutoff values for the diagnosis of abdominal obesity in korean adults.

Abdominal obesity is associated closely with insulin resistance, diabetes, and cardiovascular disease. Waist circumference (WC) is a useful surrogate marker commonly used for abdominal adiposity. The determination of WC cutoff levels is important in the prevention and treatment of obesity, type 2 diabetes, and related cardiovascular diseases. Recent epidemiological evidence suggested that appropriate optimal cutoffs for Koreans ranged over 80 to 89.8 cm in males and 76.1 to 86.5 cm in females. We analyzed the data from two large cohorts using receiver operating characteristic curve analysis with the incidences of diabetes, hypertension, dyslipidemia, cerebrovascular disease, myocardial infarct, angina, coronary artery disease, and multiple metabolic risk factors as outcome variables. Optimal WC cutoff points for Koreans were 85 cm in males and 80 cm in females. However, considering the prevalence of abdominal obesity and the health costs for its prevention and management, 90 cm in males and 85 cm in females are probably more appropriate thresholds for abdominal obesity. These values may be modified once better research is performed through prospective studies using representative populations, common health outcomes, and proper analytical approaches.

The Metabolic Syndrome among Postmenopausal Women in Rural Canton: Prevalence, Associated Factors, and the Optimal Obesity and Atherogenic Indices

ObjectivesThis research aimed to (i) determine the prevalence of metabolic syndrome (MetS) and its components; (ii) assess factors associated with MetS, and (iii) define optimal ethnic-specific cutoffs of obesity- and atherogenic-based markers to predict MetS among postmenopausal women in rural Canton.Methodology/Principal FindingsThe Rural Canton Diabetes and Metabolic Disorders Study, a population based cross-sectional study, was conducted during 2011–2012 in Canton. In person interviews, blood glucose and lipid measurements were completed for 4,706 postmenopausal women who did not receive hormone replacement therapy. MetS was diagnosed using criteria of the Joint-Interim-Statement (JIS), the International-Diabetes-Federation (IDF) and the Modified-Third-Adult-Treatment-Panel (M-ATPIII). Age-standardized prevalence of MetS was 38.4%, 28.8%, and 37.1% according to JIS, IDF, and M-ATPIII criteria, respectively. Excellent agreement was observed between three definitions (κ≥0.79), in particular between JIS and ATPIII (κ = 0.98, 95%CI: 0.97–0.98). Factors positively associated with MetS were living in Southern Canton, personal income, current smoking, higher BMI, and family history of cardiovascular disease. However, regular leisure-time physical activity can have protective effects. The optimal cutoff values for waist-circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio(WHtR), BMI, HDL-cholesterol to total cholesterol ratio (HDL/TC), HDL-cholesterol to LDL-cholesterol ratio (HDL/LDL), and triglyceride to HDL-cholesterol ratio (TG/HDL) that predicted the presence of MetS were 79.5 cm, 0.86, 0.53, 22.47 kg/m2, 0.33, 0.68, and 0.88, respectively.ConclusionsThis study highlights the importance of MetS among postmenopausal women in rural Canton. Our findings contribute to help selecting Cantonese-specific markers to predict MetS and support the need to establish educational program for promoting healthy-lifestyles among this population.