Optimal Waist Circumference Cut-off Points Research Articles

Cutoff Points of Waist Circumference for Predicting Incident Non-Alcoholic Fatty Liver Disease in Middle-Aged and Older Korean Adults.

This study aimed to determine the optimal cutoff value of waist circumference (WC) for predicting incident NAFLD. In this community-based prospective cohort study, we analyzed data from 5400 participants without NAFLD at baseline aged 40–69 years. NAFLD was defined as a NAFLD-liver fat score >−0.640. A Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for an association between body composition and NAFLD incidence. The predictive power of each body composition indicator was assessed by Harrell’s concordance index for Cox models. During a mean follow-up period of 12 years, there were 2366 new-onset NAFLD events. Compared with men with WC < 81 cm, the adjusted HR (95% CI) for incident NAFLD in those with WC ≥ 81 cm was 2.44 (2.23–2.67). Compared with women with WC < 78.5 cm, the adjusted HR (95% CI) for incident NAFLD in those with WC ≥ 78.5 cm was 2.54 (2.25–2.87). WC was the most significant risk factor for predicting incident NAFLD among body composition indicators in middle-aged and older Korean adults. The optimal WC cutoff point for predicting incident NALFD was 81 cm in men and 78.5 cm in women, which might assist in the early detection and prevention of NAFLD.

The optimal WC cut-off points for the prediction of subclinical CVD as measured by carotid intima-media thickness among African adults: a cross-sectional study

BackgroundIncreased waist circumference (WC) is one of the cardiovascular disease (CVD) risk factors used to predict cardiovascular events. Waist circumference cut-off values for predicting metabolic syndrome and other cardiovascular risks have been previously studied. Carotid intima-media thickness (CIMT) is one of the cardiovascular risk factor recently described and reported to be suitable as it is a direct measurement of vascular quality. Hence the aim of the present study was to determine the optimal WC cut-off point for the prediction of subclinical CVD.MethodsThe study was a cross-sectional study using quantitative methods, conducted among 1318 adults aged between 40 and 60 years old, residing in a rural Black population in Limpopo province. Carotid Intima-Media Thickness measurements were performed using a LOGIQ ultrasound system (GE Healthcare, CT, USA). Waist Circumference (WC) (cm) was measured to the nearest 0.1 cm. Bivariate correlation, logistic regression and receiver operating characteristic were analysed using the statistical package for social sciences version 26.0 software.ResultsAmong the total population, 69% were women and 31% men with a mean age of 53 ± 7 years. Among women, WC at a cut-off value of 95 cm gave the highest sensitivity of 57%, the specificity of 55% and an area under the curve (AUC) of 0.588. In men, an optimum WC cut-off point of 82 cm yielded the highest sensitivity and specificity at 72% and 70% respectively, with an AUC of 0.767 p < 0.001.ConclusionThe traditional waist circumference cut-off points (94 cm for women and 80 cm for men) that are currently used for the diagnosis of metabolic syndrome might not be suitable in the prediction of an increased CIMT.

Optimal waist circumference cut-off points and prediabetic state as predictors of metabolic syndrome prevalence among Saudi adults in Jeddah city

Optimal waist circumference cut-off points and prediabetic state as predictors of metabolic syndrome prevalence among Saudi adults in Jeddah city

Optimal waist circumference cut-off points and prediabetic state as predictors of metabolic syndrome prevalence among Saudi adults in Jeddah city

With increasing prevalence of metabolic syndrome and absence of local waist circumference cut-off point, it is important to determine the local cut-off point of waist circumference to predict metabolic syndrome. The aim of this study is to estimate the prevalence of metabolic syndrome among Saudi adults who attend primary health care centers (PHC) in Jeddah city in 2017, and to determine the appropriate waist circumference cut-off value for identifying a person at risk for the metabolic syndrome. A cross-sectional analytic study was conducted. Results shows; mean age of participants was 30.94±9.70 and waist circumference was 96.87±17.40 in males and 86.51±15.30 in females. The prevalence (CI: 95%) of pre-diabetes was 16.3% (12.9%; 20.1%), while the prevalence of metabolic syndrome was {(95% CI = 10.6%) (7.80%; 13.8%)}. Abdominal obesity was the most frequent component of MetS, detected in 60.6%, and followed by high blood pressure in 25.0%. In males, a waist circumference≥93.5 cm is likely to indicate MetS with 100% sensitivity and 47.2% specificity; whereas, in females, optimal waist circumference cut-off was determined as ≥83.5 cm, showing 92.3% sensitivity and 46.4% specificity. In multivariate logistic regression, extended waist circumference was the strongest predictor of MetS {OR (95%CI) =3.75 (1.30; 10.81); p=0.014}, followed by the presence pre-diabetes {OR (95%CI) =2.31 (1.06; 5.04); p=0.035}. Further, high educational level was a significant predictor for MetS {OR (95%CI) = 0.34 (0.12; 0.99); p=0.047}; while age and marital status were not significant predictors.

The correlation between proinsulin, true insulin, proinsulin: True insulin ratio, 25(OH) D3, waist circumference and risk of prediabetes in Hainan Han adults.

PurposeDiabetes mellitus is a kind of highly prevalent chronic disease in the world. The intervention measures on the risk factors of prediabetes contribute to control and reduce the occurrence of diabetes. This study aimed to investigate the correlation between proinsulin (PI), true insulin (TI), PI/TI, 25(OH) D3, waist circumference (WC), and risk of prediabetes.MethodsIn this cross-sectional study, 1662 subjects including 615 prediabetes and 1047 non-prediabetes were recruited. Spearman’s correlation analysis was used to explore the association of PI, TI, PI/TI, 25(OH) D3, and waist circumference with prediabetes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression. Receiver-Operator Characteristic (ROC) curve was used to evaluate the risk of prediabetes.ResultsOur study showed that FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC could enhance the risk of prediabetes (OR 1.034; OR 1.007; OR 1.005; OR 1.002; OR 3.577, OR 1.053, respectively; all p< 0.001). Stratified analyses indicated that FPI/FTI associated with an increased risk of prediabetes in men (OR 2.080, p = 0.042). FTI have a weak association with prediabetes risk in men and women (OR 0.987, p = 0.001; OR 0.994, p = 0.004, respectively). 2hPI could decrease prediabetes in women (OR 0.995, p = 0.037). Interesting, the sensitivity (86.0%) and AUC (0.942, p< 0.001) of combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) were higher than the diagnostic value of these alone diagnoses. The optimal cutoff point of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC for indicating prediabetes were 15.5 mU/l, 66.5 mU/l, 71.5 mU/l, 460.5 mU/l, 35.5 ng/ml, and 80.5 cm, respectively. What’s more, the combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) significantly improved the diagnostic value beyond the alone diagnoses of prediabetes in men and women (AUC 0.771; AUC 0.760, respectively).ConclusionThe FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC significantly associated with an increased risk of prediabetes. The combination of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC might be used as diagnostic indicators for prediabetes.

Predicting metabolic syndrome by anthropometric measures among adults 35–65 years in the west of Iran; a cross sectional study from an Iranian RaNCD cohort data

AimsAnthropometric indices have been proposed for the early detection of metabolic syndrome (MetS) and its risk factors. The present study aimed to determine optimal cutoff points for the Body Mass Index (BMI), Waist Circumference (WC), and Waist Hip Ratio (WHR) in the prediction of MetS. MethodsThis cross-sectional study was performed on 9746 adults 35–65 years, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort. The receiver operating characteristic (ROC) curve analysis was used to compare the predictive validity and determine optimal cutoff values. ResultsThe optimal cutoff points for BMI, WC and WHR were 27.3 kg/m2 (AUC: 78.6; 95%CI 77.1, 80.1), 97 cm (AUC: 63.8; 95%CI 60.4, 67.2) and 0.95 (AUC: 75.5; 95% CI 73.9, 77.1), respectively in men for the prediction of MetS. But in women the optimal cutoff points for BMI, WC and WHR were 28.6 kg/m2 (AUC: 65.7; 95%CI 62.1, 69.4), 98.1 cm (AUC: 65.6; 95%CI 62.4,68.8) and 0.95 (AUC:62.39; 95%CI 60.9,63.9). The risk of MetS in men and women with a BMI higher than the optimal cutoff point was respectively 2.23 and 2.30 times higher than that in those with a WC lower than the cutoff point. ConclusionsBMI is a better predictor of MetS than WC and WHR in adults 35–65 years. We recommend that the optimal cut off point be set for men 27.3 kg/m2 and for women 28.6 kg/m2.

Optimal cut-off points for waist circumference in the definition of metabolic syndrome in Chile.

To identify sex-specific cut-off points for waist circumference (WC) in the definition of metabolic syndrome (MetS) for the Chilean adult population. MetS was defined as the presence of at least two out of four of the following criteria: TAG ≥1·7 mmol/l; HDL-cholesterol: <1·3 mmol/lin women and <1·0 mmol/l in men; systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥85 mmHg; and fasting glucose ≥ 5·6 mmol/lor current treatment for diabetes. The receiver operating characteristics curve and the AUC were computed to derive the specificity and sensitivity using bootstrapping (10000 iterations restricted to have at least between 40 and 60 % of the original population). The optimal cut-off point for the Chilean population was computed by sex. A representative sample of the Chilean population aged ≥15 years. 8182 participants (60 % women) from the three available Chilean National Health Surveys conducted in 2003, 2009-2010 and 2016-2017. WC had a good predictive ability for MetS (AUC for men 0·74 (95 % CI 0·72, 0·76); AUC for women 0·71 (95 % CI 0·68, 0·73)). The optimal cut-off points for WC, in the definition of MetS, were 92·3 cm (95 % CI 90·5, 94·4) and 87·6 cm (95 % CI 85·8, 92·1) for men and women, respectively. The mentioned cut-off points should be used for WC in the definition of MetS in Chile. As a result, the current recommendation (WHO/International Diabetes Federation) for WC, in the identification of MetS, is not supported by these findings in a representative sample of the Chilean adult population.

A study of the correlation of waist circumference with metabolic risks among non-obese populations.

To investigate the correlation of waist circumference with metabolic risks among non-obese populations. A retrospective analysis was conducted for the clinical information of 13,145 non-obese subjects who received physical examinations in the hospital from January 2015 to January 2018. Among them, 1,971 subjects were definitely diagnosed with diabetes mellitus, hypertension, and metabolic syndrome and set as the metabolic disorder group, with the remaining 11,174 cases as the control group. All metabolism-related indicators were compared between the patients in the two groups, the analysis was performed for the prevalence of diabetes, hypertension, and metabolic syndrome in patients with different waist circumference as well as males and females with different waist circumferences. Finally, the optimal cut-off points of waist circumference were determined. According to the comparison, there were no statistically significant differences in subjects with low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol between the metabolic disorder group and the control group (p>0.05). The subjects in the metabolic disorder group had higher waist circumference, waist-to-hip ratio, triglyceride, fasting insulin, fasting blood glucose, and insulin resistance index than those in the control group, displaying statistically significant differences (p<0.05). When waist circumference was more than 70 cm, as it increased, the prevalence rates of diabetes, hypertension, and metabolic syndrome gradually elevated. When waist circumference was 60-90 cm, hypertension took the leading place in metabolic disorders, so did the metabolic syndrome and diabetes, with a waist circumference of more than 90 cm. There were no remarkable differences in the prevalence rates of diabetes, hypertension, and metabolic syndrome among male and female patients with different waist circumferences ((p>0.05). The patients with the waist circumference of over 90 cm exhibited gradually declined prevalence rates of diabetes, hypertension, and metabolic syndrome, while those in the patients with a waist circumference of 60-90 cm were gradually increased. The optimal cut-off points of waist circumference were calculated according to the prevalence rates of diabetes, hypertension, and metabolic syndrome among patients, and the calculation results were 78 cm, 79 cm, and 77 cm for male patients and 73 cm, 78 cm, and 73 cm for female patients. Based on the weight combined with the optimal cut-off points of waist circumference, the optimal waist circumference cut-off points for males and females were 78 cm and 74 cm, respectively. There is a correlation between the waist circumference and metabolic risks among non-obese populations, but the screening for metabolic diseases should be conducted among males with a waist circumference of over 78 cm and females with a waist circumference of over 74 cm. The treatment measures are supposed to be taken promptly to improve the prognosis.

Abdominal obesity is a common finding in normal and overweight subjects of Chile and is associated with increased frequency of cardiometabolic risk factors.

Background/ObjectivesAbdominal obesity (AO) is associated with elevated risk for cardiovascular diseases; however, this association is less clear for non-obese people. We estimated the association of AO and cardiovascular risk factors (CVRF) and disease in non-obese adult individuals from Chile.Subjects/Methods5248 adults (15 years of age or older) of both sexes from the Chilean National Health Survey (October 2009 –September 2010, response rate 85%.) were included. Information on myocardial infarction and stroke was self-reported. BMI, waist circumference (WC), arterial pressure, plasma glucose, and cholesterol levels were measured. Predictive accuracy of WC was evaluated by area under curve of receiver operating characteristic analysis and cut off points were established by Youden Index. Relationship between AO and CVRF was analyzed by Chi-squared tests.ResultsNormal weight/overweight/obesity were present in 34.4%/45.2%/18.1% of men and 33.4%/33.6%/27.5% of women. Predictive accuracy of WC to identify at least one CVRF was 0.70/0.67 and optimal cutoff points for WC in non-obese subjects were 91/83 cm in men/women, respectively. AO was present in 98.2%/99.1% of obese, 70.5%/77.4% of overweight and 12.4%/16.4% of normal weight men/women. AO was associated with increased frequency of CVRF in overweight men (6/8 and stroke) and women (4/8) and higher frequency in normal weight men (8/8 and myocardial infarction/stroke) and women (6/8 and myocardial infarction).ConclusionsWC cutoff points calculated for non-obese chilean population discriminate more differences in CVRF in normal weight woman. AO significantly increases the frequency of CVRF and diseases in overweight and especially normal weight individuals. WC can be used as a low cost, feasible and reproducible predictor for CVRF in non-obese individuals in most clinical settings.

Study on the prevalence rate and optimal waist circumference cut-off points of obesity for the components of metabolic syndrome in Uygur from Xinjiang

Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang. Methods A questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random sampling in Uygur residents above 18 years old in Xinjiang. There were 3 542 samples collected, based on the International Diabetes Federation (IDF) standard of metabolic syndrome, the relativities of clustering of metabolic syndrome components and different strata of waist circumference for Uygur were analyzed, and looking for the appropriate cut-off points for identifying two or more components of metabolic syndrome within the shortest distance of receiver operating characteristic (ROC) curve. Results According to IDF standard, the waist circumference (85 cm for men, 82 cm for women) corresponded to the shortest distance in ROC curve, at these cut-offs of abdominal obesity for component of metabolic syndrome, the prevalences of metabolic syndrome were 21.3%, 19.5% in men, while 23.0% in women, the prevalence of women was higher than that of men (P<0.05). The prevalences of ≥1, ≥2 components of metabolic syndrome were shown an increasing trend with the increasing size of waist circumference, and the odds ratio of clustering of metabolic syndrome components were also increased significantly. Conclusion The prevalence of metabolic syndrome among Xinjiang Uygur population was higher than that of national level. The cut-off points of waist circumference (85 cm for men, 82 cm for women) combining other components definition of IDF standard were recommended for identifying metabolic syndrome of Uygurs. (Chin J Endocrinol Metab, 2018, 34: 211-216) Key words: Metabolic syndrome; Uygur; Component of obesity; Cut-off points of waist circumference; Prevalence rate

The Optimal Ethnic-Specific Waist-Circumference Cut-Off Points of Metabolic Syndrome among Low-Income Rural Uyghur Adults in Far Western China and Implications in Preventive Public Health

Background: Metabolic syndrome is pandemic; however, the cut-off values for waist circumference (WC) vary widely depending on the ethnic groups studied and the criteria applied for WC measurement. Previous studies for defining optimal WC cut-off points included high-income and urban settings, and did not cover low-income, rural settings, especially for ethnic minorities. This study aimed at defining optimal ethnic-specific WC cut-off points in a low-income, rural population comprising the largest inhabitant minority group residing in far Western China. Methods: Questionnaire-based surveys, physical examinations, and blood testing of 3542 individuals were conducted in 2010, using a stratified cluster random sampling method in rural Uyghur residents (≥18 years old) from 12 villages in Xinjiang, China, approximately 4407 km away from the capital city, Beijing. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Optimal, ethnic-specific WC cut-off values for diagnosing metabolic syndrome were determined using receiver operator characteristic (ROC) curve analysis. Results: As WC increased, there was a significant, increasing trend of detection and risk in rural Uyghur adults, regardless of the presence of ≥1 or ≥2 components of metabolic syndrome by IDF criteria. The optimal ethnic-specific WC cut-off point to predict the presence of metabolic syndrome was 85 cm for men and 82 cm for women. With these cut-off points, the prevalence rates of metabolic syndrome among men, women, and overall population in Uyghur adults were 19.5%, 23.0%, and 21.3%, respectively. Conclusions: We report a high prevalence of metabolic syndrome, especially in women, among rural Uyghurs in Western China. A WC cut-off of 85 cm in men and 82 cm in women was the best predictor of metabolic syndrome in this population. Because of the cost-effectiveness in measuring WC, we recommend that these WC cut-off points be integrated into local preventive policies for public health as the primary screening criteria for metabolic syndrome and related diseases among low-income, rural minorities.

A cross sectional study on the predictive value of body mass index and waist circumference for the risk of hypertension and diabetes of the residents in Xuzhou City

Objective To explore the optimal cut-off points of body mass index(BMI)and waist circumference(WC)in predicting hypertension, diabetes, and the risk of diseases at different status of BMI and WC. Methods With the multistage randomized cluster sampling, questionnaire survey and physical examination were carried out among 2 246 permanent residents aged 18 years and over in 11 communities of Quanshan, Xuzhou. Receiver operating characteristic curves(ROC)were used to calculate the optimal cut-off points of BMI and WC in detecting hypertension and diabetes. Non-conditional logistic regression was used to analyze the association of the risk of hypertension and diabetes with different status of BMI and WC. Results The rates of overweight, obesity based on BMI and central obesity in 2 246 subjects were 37.3%, 9.2%, and 44.9% respectively. The optimal cut-off points of BMI in predicting hypertension and diabetes were 24.6 and 26.1 kg/m2 in men, and 23.7 and 23.6 kg/m2 in women, respectively. The optimal cut-off points of waist circumference in predicting hypertension and diabetes were 84.8 and 89.9 cm in men, and 78.1 and 78.1 cm in women, respectively. After adjusting for potential confounding factors, comparing with normal subjects, the risks of hypertension were 1.529(95%CI 1.047-2.234), 2.386(95%CI 1.744-3.263), and 3.755(95%CI 2.506-5.627)in central obesity subjects with normal weight, overweight, and obesity based on BMI, and 1.813(95%CI 1.271-2.586)in obese subjects with normal WC. Comparing with normal subjects, the risks of diabetes were 2.282(95%CI 1.225-4.252), 2.964(95%CI 1.741-5.044), and 3.900(95%CI 2.077-7.322)in central obesity subjects with normal weight, overweight, and obesity based on BMI, and 5.016(95%CI 1.474-17.068)in obese subjects with normal WC. Conclusion The optimal cut-off points of BMI and WC in predicting the risk of diabetes were greater than those for hypertension in men, and similar in predicting diabetes and hypertension in women. The risk of hypertension in central obesity population was increased with the increase of BMI. WC showed greater impact on blood pressure compared with BMI. (Chin J Endocrinol Metab, 2016, 32: 803-807) Key words: Body mass index; Waist circumference; Hypertension; Diabetes

Is the 90th Percentile Adequate? The Optimal Waist Circumference Cutoff Points for Predicting Cardiovascular Risks in 124,643 15-Year-Old Taiwanese Adolescents.

Adolescent obesity has increased to alarming proportions globally. However, few studies have investigated the optimal waist circumference (WC) of Asian adolescents. This study sought to establish the optimal WC cutoff points that identify a cluster of cardiovascular risk factors (CVRFs) among 15-year-old ethnically Chinese adolescents. This study was a regional population-based study on the CVRFs among adolescents who enrolled in all the senior high schools in Taipei City, Taiwan, between 2011 and 2014. Four cross-sectional health examinations of first-year senior high school (grade 10) students were conducted from September to December of each year. A total of 124,643 adolescents aged 15 (boys: 63,654; girls: 60,989) were recruited. Participants who had at least three of five CVRFs were classified as the high-risk group. We used receiver-operating characteristic curves and the area under the curve (AUC) to determine the optimal WC cutoff points and the accuracy of WC in predicting high cardiovascular risk. WC was a good predictor for high cardiovascular risk for both boys (AUC: 0.845, 95% confidence interval [CI]: 0.833–0.857) and girls (AUC: 0.763, 95% CI: 0.731–0.795). The optimal WC cutoff points were ≥78.9 cm for boys (77th percentile) and ≥70.7 cm for girls (77th percentile). Adolescents with normal weight and an abnormal WC were more likely to be in the high cardiovascular risk group (odds ratio: 3.70, 95% CI: 2.65–5.17) compared to their peers with normal weight and normal WC. The optimal WC cutoff point of 15-year-old Taiwanese adolescents for identifying CVRFs should be the 77th percentile; the 90th percentile of the WC might be inadequate. The high WC criteria can help health professionals identify higher proportion of the adolescents with cardiovascular risks and refer them for further evaluations and interventions. Adolescents’ height, weight and WC should be measured as a standard practice in routine health checkups.

Lms Tables For Waist Circumference And Waist-height Ratio In Colombian Adults

PURPOSE: Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). The aims of this study were to establish a Colombian smoothed centile charts and LMS tables for WC and WHtR; appropriate cut-offs were selected using receiver operating characteristic analysis based on data from the Colombian representative sample. METHODS: We used data from the cross-sectional, national representative nutrition survey, 2010. A total of 83,220 participants (aged 20-64 years) were enrolled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles were calculated using the LMS method. Receiver operating characteristics curve analyses were used to evaluate the optimal cut-off point of WC and WHtR for overweight and obesity based on the WHO definitions. RESULTS: We found a strong positive correlation between WC and BMI (r=0.847, p < .01) and WHtR and BMI (r=0.878, p < .01). To overweight category in men, the cut-off point value of 87.6 cm for the WC provided a sensitivity of 87.6%, a LR (+) value of 7.01, specificity of 87.5% and LR (-) value of 0.14. In women, the cut-off point value of 84.0 cm for the WC provided a sensitivity of 84.0%, a LR (+) value of 7.30, specificity of 88.5% and LR (-) value of 0.18. In obesity category in men, the cut-off point value of 96.6 cm for the WC provided a sensitivity of 92.9%, a LR (+) value of 7.31, specificity of 87.3% and LR (-) value of 0.08. In women, the cut-off point value of 91.0 cm for the WC provided a sensitivity of 89.2%, a LR (+) value of 6.42, specificity of 86.1% and LR (-) value of 0.13. ROC curve for WHtR was also obtained and the cut-off point value of 0.521 was used. To overweight category considering this cutoff point, in men sensitivity was 88.8%, LR (+) value of 5.80, specificity 84.7% and LR (-) 0.13. In women the cut-off point value was 0.536, sensitivity 85.8%, LR (+) value of 6.01, specificity 85.8% and LR (-) 0.17. To obesity in men the cut-off point value of 0.579 was used. The sensitivity was 90.7%, LR (+) value of 6.98, specificity 87.0% and LR (-) 0.11. In women, the cut-off point value was 0.587 with sensitivity 84.5%, LR (+) value of 5.80, specificity 84.5% and LR (-) 0.12. CONCLUSIONS: By providing LMS tables for adults based on Colombian reference data, we hope to provide quantitative tools for the study of obesity and its complications.

LMS tables for waist circumference and waist-height ratio in Colombian adults: analysis of nationwide data 2010.

Background/Objectives:Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample.Subjects/Methods:We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20–64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions.Results:Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained.Conclusions:This study presents first reference values of WC and WHtR for Colombians aged 20–64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications.

Optimal waist circumference cut-off points and ability of different metabolic syndrome criteria for predicting diabetes in Japanese men and women: Japan Epidemiology Collaboration on Occupational Health Study.

BackgroundWe sought to establish the optimal waist circumference (WC) cut-off point for predicting diabetes mellitus (DM) and to compare the predictive ability of the metabolic syndrome (MetS) criteria of the Joint Interim Statement (JIS) and the Japanese Committee of the Criteria for MetS (JCCMS) for DM in Japanese.MethodsParticipants of the Japan Epidemiology Collaboration on Occupational Health Study, who were aged 20–69 years and free of DM at baseline (n = 54,980), were followed-up for a maximum of 6 years. Time-dependent receiver operating characteristic analysis was used to determine the optimal cut-off points of WC for predicting DM. Time-dependent sensitivity, specificity, and positive and negative predictive values for the prediction of DM were compared between the JIS and JCCMS MetS criteria.ResultsDuring 234,926 person-years of follow-up, 3180 individuals developed DM. Receiver operating characteristic analysis suggested that the most suitable cut-off point of WC for predicting incident DM was 85 cm for men and 80 cm for women. MetS was associated with 3–4 times increased hazard for developing DM in men and 7–9 times in women. Of the MetS criteria tested, the JIS criteria using our proposed WC cut-off points (85 cm for men and 80 cm for women) had the highest sensitivity (54.5 % for men and 43.5 % for women) for predicting DM. The sensitivity and specificity of the JCCMS MetS criteria were ~37.7 and 98.9 %, respectively.ConclusionData from the present large cohort of workers suggest that WC cut-offs of 85 cm for men and 80 cm for women may be appropriate for predicting DM for Japanese. The JIS criteria can detect more people who later develop DM than does the JCCMS criteria.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2856-9) contains supplementary material, which is available to authorized users.

Performance of waist circumference and proposed cutoff levels for defining overweight and obesity in Nigerians

Background:Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data.Objectives:To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values.Subjects and Methods:Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization's STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P < 0.05.Results:A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities.Conclusions:The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.

Determination of the Optimal Waist Circumference Cut-Off Points in Benin Adults

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.

Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among adult Egyptian population.

Objective:To determine the best anthropometric measurement of obesity, and its optimal cutoff, that best predicts the presence of cardiovascular risk factors among adult Egyptian population.Methods:This is a cross-sectional study including a representative randomly chosen sample of the adult Egyptian population from all Alexandria Districts (the second largest governorate in Egypt) based on the multistage random technique. It included 3209 subjects (1567 men, 1642 women) aged 18–80 years from urban and rural areas. The response rate was 80.2%. History, blood pressure, and anthropometric measurements were taken. Laboratory investigations included fasting lipid profile, fasting plasma glucose, and serum uric acid. Different criteria of metabolic syndrome were used and compared. Receiver operator characteristic curve and Youden index were used to determine predictability and cutoffs.Results:Waist circumference (WC) is the best to predict at least two other components of the metabolic syndrome as defined by the International Diabetes Federation (IDF). The optimal WC cutoffs were 100.5 and 96.25 cm for Egyptian men and women, respectively. The Joint Interim Statement definition (JIS) of metabolic syndrome was the best to predict cardiovascular disease in both genders and diabetes mellitus in women. The prevalence of metabolic syndrome and abdominal obesity was 42.5%, 61%, respectively (ATPIII definition); 43.8%, 61% (American Heart Association definition); 44.3%, 76.4% (IDF definition); 33.8%, 51.7% (IDF definition with Egyptian cutoffs); and 41.5%, 51.7% (JIS with Egyptian cutoffs).Conclusion:WC cutoffs in Egyptians differ from those currently recommended. Prevalence of metabolic syndrome and abdominal obesity is high in Egypt, despite being lower on using the Egyptian cutoffs.

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.