Points Of Waist Circumference Research Articles

1437-P: Waist-to-Height Ratio Is a Better Indicator Instead of Waist Circumference for Diagnosing Metabolic Syndrome in Type 2 Diabetes

Waist circumference (WC) is currently one of the components of metabolic syndrome (MetS) , but the cutoff points of WC for diagnosing MetS vary between races and genders. Therefore, the aim of this study is to search an anthropometric indicator instead of WC that would be applicable across races and genders. Our previous study found that a waist-to-height ratio (WHtR) >= 0.52 has excellent diagnostic value for MetS in both men and women with type 2 diabetes mellitus (T2DM) . We therefore selected 8525 T2DM patients with complete clinical data in the present study. Agreement between a WHtR >= 0.52 and different WC diagnostic criteria for men (>=90cm) and women (>=80cm) was almost perfect (Kappa=0.911) . As a component of MetS instead of WC, the AUC of new criteria using WHtR to diagnose MetS was 0.963 in T2DM patients. Using a WHtR cut-off of 0.52 most closely associated with the prevalence of MetS in man (98.0% sensitivity and 94.7% specificity) and women (95.7% sensitivity and 98.0% specificity) participants and. Taken together, the use of WHtR instead of WC is a simple and practical indicator for the diagnosis of MetS in T2DM. Disclosure J.Ke: None. J.Wang: None. Y.Ma: None. Y.Wang: None. L.Li: None. Funding National Natural Science Foundation of China (81770813, and 82070866) .

1234-P: Serum Fatty Acid Composition as a Biomarker of Diabetes Development: Tokushima Cohort Study

Few prospective cohort studies still exist on the association between serum fatty acid (FA) proportions and the enzymes involved in their synthesis and the onset of type 2 diabetes (T2D) . Thus, the aim of the present study was to investigate whether or not serum FA proportions or FA ratios, which reflect desaturase activities, are associated with the incidence of T2D. Here we analyzed data of a prospective cohort study, which was conducted during 2010-20in Japan. A total of 872 male workers without diabetes aged over 20 years were followed up prospectively. Diabetes was defined as having either: 1) fasting plasma glucose ≥ 126 mg/dl, 2) HbA1c ≥ 6.5%, 3) medication for hyperglycemia or 4) postprandial plasma glucose ≥ 200 mg/dl during the follow-up period. We measured serum FA levels and estimated the activity of ⊿5desaturase (D5D) by calculating the ratio of serum arachidonic acid to dihomo-γ-linolenic acid (DGLA) . The subjects were also divided into two groups by the cutoff point of waist circumference (WC) ≥ 90 cm. In multivariate analysis, the HR of developing diabetes was 2.81 [95%CI: 1.to 7.15, P=0.03] in the highest quartile of serum DGLA proportion and 0.28 [95%CI: 0.to 0.90, P=0.03] in the highest quartile of D5D, compared with their lowest quartiles, respectively. In stratified analysis, the multivariate adjusted risk of diabetes was higher in participants with low D5D/low WC (2.56 [0.96 to 6.82]) or high D5D/high WC (2.77 [0.68 to 11.32]) , and was significantly higher in participants with low D5D/high WC (6.30 [1.95 to 20.33, P=0.002]) than in participants with high D5D/low WC. Our findings suggest that the combination of increased serum DGLA proportion and attenuated D5D activity is a risk factor for the incidence of diabetes in male Japanese, especially in those with WC ≥ 90 cm. Thus, the significance of serum FA measurements in predicting T2D is suggested. Disclosure A.Hata: None. N.Aki: None. T.Ichihara: None. A.Tamura: None. T.Minagawa: None. Y.Kuwamura: None. M.Funaki: Board Member; Mechanogenic, Inc. Funding Grants-in-aid for research from Tokushima Prefecture Local Government

Analysis of anthropometric indicators used in the nutritional assessment of active elderly in the city of Macaé, Rio de Janeiro, Brazil

Introduction: Body composition changes related to aging alter the capacity of predicting risk through anthropometric parameters. Objective: To discuss methodological aspects of anthropometry in active elderly based on associations between Body Mass Index (BMI) and other nutritional indicators. Methods: Cross-sectional study with active elderly from Macaé, Rio de Janeiro, Brazil (2014/2015). Nutritional status was described according to the BMI (Nutritional Screening Initiative, 1994). Linear regression analysis was performed: the outcome variable was BMI and the dependent ones were circumferences of waist, hip, neck, calf, arm and waist-to-hip ratio (WHR). Results: We assessed 173 people (55.5% female; median 71 years old). Calf and neck circumferences and WHR presented low R2 value. Among women, hip (R2=0.825) and waist circumferences (R2=0.729) individually explained much of the variation in BMI; and among men, waist (R2=0.759) and arm circumferences (R2=0.741) performed better. The cut-off points for waist circumference corresponding to the critical BMI value (27 kg/m2) were 87.9 and 96.8 cm, respectively for women and men. In multiple analysis, the association of waist, hip and arm circumferences with BMI remained significant. Conclusion: Circumferences traditionally used to assess adults had higher linear association with BMI than specific indicators for elderly people. The body composition of active elderly can be more similar to adults’ than that of elderly with other profiles. The waist circumference cut-off points established for adults may not be suitable for elderly populations. We suggest testing the cut-off points obtained by this study on other groups of active elderly.

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.

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.

1481-P: Relationship among BMI, WC, and Cardiovascular Disease Risk Factors: Findings from the Korea National Health Insurance System (KNHIS) Health Checkup Data

The clinical utility of the combined use of BMI and waist circumference (WC) to indicate the cardiovascular disease (CVD) risk factors in Asians remains unclear. Using a large-scale population-based cohort from the KNHIS health checkup data from 2009 to 2015, we investigated the relationship between BMI, WC and subsequent CVD risk factors (at least one from type 2 diabetes, hypertension or dyslipidemia). BMI was categorized into 5 subgroups at 18.5, 23.0, 25.0 and 30.0kg/m2. The cut-off points of WC for central obesity were 90cm in men and 85cm in women. The participants were subdivided into a total of 10 subgroups according to the presence of central obesity in each of the 5 BMI ranges. The incidence risk of CVD risk factors in each subgroup was comparatively analyzed using a multivariable Cox's proportional hazard model. Participants were 14,170,134 adults above 20 years of age who did not have type 2 diabetes, hypertension or dyslipidemia at the baseline examinations. During a mean follow-up of 5.3 years, CVD risk factors developed in 1,857,307 participants. The HRs for CVD risk factors were increased by 8.2% per 1kg/m2 increment of BMI. The HRs (95% CI) for CVD risk factors across BMI categories were 0.573, 1.0, 1.479, 1.962 and 3.03, respectively, after adjusting for age, sex, smoking, alcohol drinking, physical activity, and monthly income. Compared to the group with BMI of 18.5 to 23 kg/m2 without central obesity, which served as the reference group, the multivariable-adjusted HRs in those with central obesity was significantly increased from 1.00 to 1.27 with a BMI of 18.5 to 23.0 kg/m2, from 1.45 to 1.64 with a BMI of 23.0 to 25.0 kg/m2, from 1.83 to 2.10 with a BMI of 25.0 to 30.0 kg/m2, and from 2.56 to 3.08 with a BMI of 30.0 kg/m2 or over. These findings show that assessment of central obesity provided additional clinical utility beyond BMI for reclassifying the risk of CVD risk factors in Korean populations, even those with a low BMI. Disclosure J. Son: None. S. Lee: None. H. Kwon: None. S. Yoo: None.

CUT OFF VALUES FOR WAIST CIRCUMFERENCE TO PREDICT OVERWEIGHT IN BRAZILIAN ADOLESCENTS, ACCORDING TO PUBERTAL STAGING.

ABSTRACTObjective: To establish waist circumference cut off points according to pubertal staging to identify overweight in adolescents. Methods: Longitudinal study approved by the Ethics Research Committee and conducted with 557 adolescents, aged 10 to 15 years old, selected from public schools. Waist, arm, neck and hip circumferences, body fat percentage, body mass index (BMI), height and blood pressure were measured. Pubertal staging was evaluated by Tanner self assessment scale. The Receiver Operating Characteristic Curve (ROC curve) was used to determine predictive power, sensitivity, specificity and waist circumference cut off points to detect overweight. Results: There was a positive correlation between waist circumference and weight, BMI, upper arm and hip circumferences, waist-to-hip ratio and blood pressure in both sexes. Cut off points for waist circumference according to pubertal stage as related to overweight in adolescents with the best performances in ROC curve were: 71.65 cm for prepubescent girls, 67.90 cm for pubescent girls, 70.25 cm for post pubescent girls, and 66.45 cm for pubescent boys. Age, weight, height, BMI, body fat percentage, arm and hip circumferences were associated to altered waist circumference. Conclusions: The establishment of cut off points for waist circumference according to pubertal staging was proven a good means to identify overweight. These cut off points can be considered reliable for the Brazilian adolescent population, as the isolated use of chronological age in adolescents may underestimate their nutritional status.

CUT OFF VALUES OF WAIST CIRCUMFERENCE AND WAIST-TO-HIP RATIO FOR PREDICTING METABOLIC SYNDROME AMONG POPULATION IN TWO COMMUNES, QUANG DIEN DISTRICT, THUA THIEN HUE PROVINCE

Background:Metabolic syndrome (MetS) is a cluster of metabolic abnormalities, characterized as central obesity, dysglycemia, raised blood pressure, elevated triglyceride (TG) level, and low high-density lipoprotein cholesterol (HDL-C) level. MetS is associated with cardiovascular disease, type 2 diabetes morbidity and mortality, and all-cause mortality. It is alarming that the prevalence of MetS is high and increasing in both developing and developed nations. Thus, early identification and treatment of individuals with MetS is essential to prevent the adverse consequences related to its development. However, the diagnostic criteria of MetS are complex to conduct, which makes early identification of individuals with MetS challenging. Of these components of MetS, central obesity is considered as the most important component. As an indirect measure of visceral fat, waist circumference (WC) and waist-to-hip ratio (WHR) are an easy, cost-effective, and non-invasive metric useful for identification of central obesity and, in turn, may be an effective predictor of the risk of metabolic syndrome. However, ethnic and racial variation among populations from different regions warrants different cutoff points to diagnose metabolic syndrome. Objective: To identify the optimal cut off values for waist circumference (WC), waist-to-hip ratio (WHR) for predicting metabolic syndrome (MetS) among population in Quang Dien District, Thua Thien Hue Province. Methods: A cross-sectional study carried out 386 people over 25 years olds chosen from two communities from Quang Dien district by stratified sampling procedure. Metabolic syndrome was defined according to the IDF, NHLBI, AHA, WHF, IAS, IASO (2009). Receiver operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cut off values of WC, WHR. Results: The optimal cut off values for WC for predicting MetS were 87 cm for men (AUC= 0.852, sensitivity = 85.7% and specificity = 83.8%) and 76 cm for women (AUC= 0.871, sensitivity = 85% and specificity = 74.73%). The optimal cut off values for WHR for predicting MetS were 0.9 for men (AUC= 0.823, sensitivity = 85.71% and specificity = 76.15%) and 0.86 for women (AUC= 0.801, sensitivity = 80% and specificity = 66.48%). Conclusion: We propose the optimal cut off point for WC, WHR for the best predictor of MetS as 87 cm, 0.9 in men and 76 cm, 0.86 in women respectively in Quang Dien population. Key words: Metabolic syndrome (MetS), metabolic abnormalities, Quang Dien district

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

Optimal Anthropometric Cutoff Points to Predict Overweight and Obesity: A Cross-Sectional Survey in Iranian Females

Background: Body mass index (BMI) is the most applicable measure to screen overweight and obesity. However, individual and demographic factors affect the BMI cutoff values. Objectives: The current study aimed to determine the cutoff points for waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR) and neck circumference (NC) as indicators of overweight and obesity in Iranian females. Methods: This cross-sectional survey was conducted on 2466 females, aged 30 - 59 years, recruited from five ethnic groups; Arab, Kurd, Sistani and Baluchi, Turk and Turkmen in Iran, from Nov 2015 to Feb 2016. The subjects were selected by cluster multistage random sampling through five provinces. Receiver operating characteristics (ROC) analyses and Youden index were used to estimate the optimal anthropometric cutoff points. Results: Overall, 38.1% of females were overweight and 38.0% were obese. Significant differences of nutritional status were observed among different ethnic groups (P < 0.001). The higher rates of overweight were observed in Kurd and Turk subject. Furthermore, the obesity was more common among Arab and Kurd subjects. Sistani and Baluchi showed the lowest rate of obesity and highest underweight. ROC analysis showed the highest area under curve (AUC) for WHtR and WC, followed by NC and WHpR was in the lowest area. The optimal cutoff points to diagnose overweight and obesity were WC, 90.25 and 95 cm, WHtR, 0.57 and 0.62, NC, 33 and 34 cm, and WHpR, 0.90 and 0.93 in total population, respectively. Conclusions: Higher cutoff values were proposed for anthropometric parameters in different ethnic groups of Iranian females compared to international cutoff points to predict overweight and obesity.

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

Abstract 14854: Optimal Cut-off Points of Waist Circumference for Detecting Central Obesity and Severe Central Obesity in Chinese Adults

Introduction: Given that no consensus has yet been reached over the optimal cut-off points of waist circumference (WC) for Chinese, this study aimed to determine the appropriate cut-off points of WC for detecting central obesity and severe central obesity in a Chinese adult population. Methods: Data from the cross-sectional survey of the PRC-USA Collaborative study of Cardiovascular and Cardiopulmonary Epidemiology in 1993-1994 was used, including 10265 subjects (4921 men and 5344 women) aged 35-69 years. Each integer of WC in centimeters was used as the cut-off point to detect clustering of cardiovascular risk factors, which was defined as the presence of two or more risk factors among hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol. Based on the Receiver operating characteristic (ROC) curve analysis, the WC value corresponding to the point on the ROC curve nearest to the upper left corner of the ROC graph was considered the optimal cut-off for central obesity and the value corresponding to the point with specificity of 90% or more was considered the optimal cut-off for severe central obesity. Results: The optimal cut-off value of WC to detect clustering of risk factors was ≥84 cm for men and was ≥80 cm for women with the shortest distance to the upper left corner being 0.4304 and 0.4504, respectively. The cut-off values of WC with specificity above 90% were ≥93 cm and ≥91 cm for men and women respectively. Conclusions: These results were equal or similar to the WC cut-off points proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, i.e., ≥85/80 cm (men/women) for increased risk for obesity related diseases and ≥95/90 cm (men/women) for much higher risk. For practical reasons, WC≥85/80 cm and ≥95/90 cm (men/women) could be the optimal cut-off values for detecting central obesity and severe central obesity, respectively, in Chinese adult population.

Cut-off values of waist circumference for central obesity in Chinese adults

To investigate the appropriate cut-off values of waist circumference(WC)for central obesity and severe central obesity in Chinese adults. A total of 10 265 participants aged 35-69 years from the cross-sectional survey of the PRC-USA Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology between 1993 and 1994 with integral data were included. Each integer unit in centimeters of WC in a given range was used as the cut-off point to detect clustering of risk factors, which was defined as an individual with 2 or more risk factors including hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol. Sensitivity, specificity and distance from the receiver operating characteristic (ROC) curves to the upper left corner of the ROC graph were calculated. The WC value corresponding to the point on the ROC curve nearest to the upper left corner was considered as the optimal cut-off value for central obesity and the value corresponding to the point with specificity of 90% or more was considered as the optimal cut-off for severe central obesity. The mean WC was (80.5 ± 9.9) cm in men and (77.8 ± 10.0) cm in women; 18.1% (890/4 921) of men and 14.5% (776/5 344) of women were identified with two or more major risk factors. Based on the ROC curve analysis, the optimal value of WC to detect clustering of risk factors was ≥ 84 cm for men and ≥ 80 cm for women, and the shortest distance to the upper left corner was 0.430 and 0.450, respectively. The cut-off values of WC to detect clustering of risk factors with specificity of 90% or more were ≥ 93 cm and ≥ 91 cm for men and women, respectively. The cut-off points of WC for central obesity and severe central obesity in Chinese adults obtained from this study are equal or similar to the WC cut-off values proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults.

Relationship between obesity and related indicators with insulin resistance among the residents over 50-year-old in Wuxi area

To analyze the relationship between obesity with related measurable indicators and insulin resistance among the residents over 50-year-old in Wuxi area.The questionnaire survey,physical examination,and relevant biochemical measurements as well as gender,age,height,body w eight,waist circumference,and hip circumference were obtained.The prevalence of obesity was 11.95％ of which 57.24％ were with central obesity,and the prevalence in male was higher than that in female(P＜0.05).With inereasing body mass index (BMI) and waist circumference(WC),the prevalence of insulin resistance increased gradually (P ＜ 0.05).Meanwhile,With the increasing HOMA-IR,the prevalence of obesity and central obesity also gradually increased (P＜0.05).BMI,WC,and waist-to-hip ratio can effectively predict insulin resistance.The cut-off point of waist circumference was 87.5 cm for male,and 84 cm for female.At the same level of body mass index,metabolic measurements in central obesity group were higher than those of non-central obesity group with the same body mass index,especially in normal weight group.The related metabolic measurements of metabolic obesity but normal weight group were mostly higher than metabolically healthy but obese group,and there were statistically significant differences in fasting blood glucose,fasting insulin,HOMA-IR and HOMA-β.Obesity,especially central obesity,is closely related to insulin resistance among residents over 50-year-old in Wuxi area.Meanwhile,waist circumference may effectively predict insulin resistance and may serve as a parameter in the occurrence of metabolic syndrome and cardiovascular diseases. Key words: Obesity ; Body mass index ; Waist circumference ; Insulin resistance

Prevalence of metabolic syndrome and its correlated factors among children and adolescents of Ahvaz aged 10 - 19.

BackgroundPopulation-based studies for prevalence of metabolic syndrome (M.S) in children and adolescents are relatively rare. The aim of this study was to assess the Prevalence of M.S and correlated factors among children and adolescents aged 10 to 19 years in Ahvaz.MethodsIn this descriptive-analytical population- based study, 2246 children and adolescents, 10–19 years old (1113 male and 1133 female) in Ahvaz, were evaluated. Anthropometry, biochemical measurement and blood pressure (BP) were assessed. Modified ATP III criteria 2005 were used for M.S. definition. Center for disease and Control preventions (CDC) percentile were applied to define cut off points of waist circumference and BP.ResultsPrevalence of M.S. was 9% (95% CI: 8-10%) with prevalence in male 11% (95% CI: 10-12%) and female 7% (95% CI 6-8%). Among individuals with M.S, triglyceride (TG) and decreased high density lipoprotein (HDL) cholesterol levels were the most common components (33.5% and 24.1%, respectively). Prevalence of M.S was higher in overweight persons comparing to participants with at risk and normal weight group (in male: 24.1%, 14.3% and 9.9% respectively P = 0.0001), (in female: 22.6%, 18.3% and 4.5% respectively P = 0.0001). Among the correlated factors of M.S age (P = 0.0006), sex and BMI (P = 0.0001) had significant differences between subjects with and without M.S. whereas there was no significant difference between two groups in ethnicity, history of breast fed, birth weight neonatal ICU admission, maternal history(GDM, gestational HTN, Parity) and family history of HTN, obesity and DM (P > 0.05).ConclusionThis study shows high prevalence of M.S in Children and Adolescents in south west of Iran (Ahvaz) especially in overweight persons.

Metabolic Syndrome (MetS)

The clinical cluster of hypertension, cardiovascular disease, hyperlipemia, hyperuricemia and type 2 Diabetes had been recognized by physicians for many decades, described as syndrome X and finally metabolic syndrome (MetS). A few decades ago, investigators noted this syndrome in the alarming pandemic of obesity and type 2 diabetes. Different definitions of metabolic syndrome had been developed by the World Health Organization (WHO), the National Cholesterol Education Program me Adult Treatment Panel 111 (NCEP-ATP111) and by the International Diabetes Federation (IDF). High Triglycerides, low HDL-C, hypertension, raised fasting plasma glucose, and central obesity are essential factors. Obligatory factors such as obesity (BMI ≥ 30) and high waist circumference with ethnic specificity were required by WHO and IDF criteria respectively. Cutoff points of systolic and diastolic blood pressures, HDL-C and fasting plasma glucose of WHO criteria were required to be adjusted; and cutoff points of waist circumference for males and females of IDF were required to be standardized with European and non-European populations, South Asians and South-East Asians of WHO and IDF criteria. Later, three out of five criteria was introduced by NCEP ATP111 instead of obligatory requirements plus two out of four criteria used by WHO and IDF. To be practical for application to public health sectors, MetS has been defined by at least two criteria such as hypertriglyceridemia-waist and hypertensive-waist by validation to IDF criteria definition. Some elements of MetS are noted to be clustered more frequently in some ethnic populations. Individuals without type 2 DM, obesity or MetS are noted to have low HDL-C regardless of age in some populations, probably based on genetic susceptibility. Gender also has an impact on HDL-C level, lower in females than males in general. Then, triglycerides and total cholesterol levels increase with age.

Determining the optimal cutoff points for waist circumference and body mass index for identification of metabolic abnormalities and metabolic syndrome in urban Thai population

This study describes the prevalence and optimal waist circumference (WC) and body mass index (BMI) cutoff point for metabolic abnormalities and metabolic syndrome (MS) from urban Thai population. The optimal BMI/WC cutoff has been used for identifying and evaluating metabolic abnormalities for screening individuals having risk factor of MS.

Prevalence of the Metabolic Syndrome in the Yan-an Region of Northwest China

To evaluate the prevalence of the metabolic syndrome in a sample population from northwest China, and to determine the optimal cut-off point for waist circumference for diagnosing the metabolic syndrome in this population. A total of 1290 residents of the Yan-an region of China completed a cross-sectional survey, physical examination and laboratory tests. The International Diabetes Federation (IDF), Chinese Diabetes Society (CDS), and the National Cholesterol Education Program Adults Treatment Panel-III (NCEP-ATPIII) criteria were used to assess the prevalence of the metabolic syndrome and its relationship with age and gender. According to the NCEP-ATPIII, CDS and IDF diagnostic criteria, the prevalence of the metabolic syndrome was 15.8%, 20.4% and 26.4%, respectively. The optimal cut-off point for waist circumference was ≥ 86.5 cm for men and ≥ 80.5 cm for women. The prevalence of the metabolic syndrome in the Yan-an region was significantly higher than that in other regions of China, and participants with the metabolic syndrome were much younger than those in other Chinese regions.

Correlation of Hypertension with Waist Circumference in Iranian Adults

Cardiovascular disease (CVD) is the most important cause of mortality in developed and developing countries. Hypertension is a major risk factor for CVD. Waist circumference (WC) cut-off point is a simple way to recognize risk of developing hypertension. However, there are different cut-off points for different races, including Iranians. The objective of this article was to determine the association between WC and hypertension as an important cardiovascular risk factor in the Iranian population. A total of 850 subjects (430 women and 420 men) older than 18 years, who were residents in the urban and rural areas throughout Arak city, Iran, were included in the present study. WC of subjects was measured to identify its relationship with hypertension. Fasting plasma glucose and lipid profile were also measured. WC cut-off point to predict hypertension was 89 cm and 93 cm for men and women, respectively, by using receiver operator characteristic curve analysis. The results of our analysis showed that the cut-off point of WC in the Iranian population is greater than other Asians and WC is a strong index to predict hypertension.

Anthropometric indices of central obesity how discriminators of metabolic syndrome in Brazilian women with polycystic ovary syndrome

Background: Central obesity is highly prevalent in women with polycystic ovary syndrome (PCOS) and is strongly associated with metabolic syndrome (MetS). Objectives: To define cut-off points of waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and conicity index (C-Index) to discriminate metabolic syndrome (MetS) in Brazilian women with PCOS. Methods: In a cross-sectional study, anthropometric, biochemical and clinical parameters were measured in 113 Brazilian PCOS women (27.2 ± 4.5 years). Receiver operating characteristic (ROC) analysis was used to find out the cut-off points of anthropometric indices to predict MetS according with National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria. Results: Considering the ROC curve analysis the WC and WHtR had a similar performance in predicting MetS and these parameters were better than WHR and C-Index. The optimal cut-off values of the anthropometric indices for discriminate MetS were: WC = 95 cm; WHtR = 0.59; WHR = 0.88; and C-Index = 1.25. By using these cut-off points the sensitivity and specificity rates of WC and WHtR were higher than those observed for WHR and C-Index.Conclusion: Our results indicated that WC and WHtR are more accurate than WHR and C-Index to predict MetS in Brazilian PCOS women.