Waist Circumference Cutoff Research Articles

Abstract 17973: Clinical Markers Associated With Subclinical Atherosclerosis in Otherwise Apparently Healthy Young Adults

Introduction: Traditional risk factors are poor predictors of cardiovascular events in younger adults. Considering the long silent evolution of atherosclerosis beginning in younger adulthood before the appearance of clinical events at a more advanced age, a simple tool to predict early atherosclerosis in young adults would be desirable to guide primordial prevention. An altered cardiometabolic profile is associated with increased cardiovascular disease in older adults independent from traditional risk factors, but the value of this profile in an otherwise healthy young adult population is unknown. Hypothesis: Cardiometabolic risk markers would be associated with early atherosclerosis in young adults despite the absence of traditional risk factors. Methods: Healthy young adults (18-35 years) devoid of cardiovascular risk factors (diabetes, smoking, hypertension, dyslipidemia) and obesity were prospectively enrolled. Anthropometric measurements, ECG, lipid profile, fasting blood glucose, blood pressure and high-resolution carotid artery MRI were realized. Results: Although the 240 participants (25.8 years, SEM=0.29, 48% women) were at low risk for atherosclerosis, we identified atherosclerosis in 72.6% of men and 64.7% of women (p=0.19). Males had greater atherosclerosis burden vs. females (carotid wall volume [CWV]: 1817 mm3/48mm, SEM=29.7 vs. 1579 mm3/48mm, SEM=21.2; p<0.0001). By multivariate analysis, atherosclerosis burden was associated with fasting blood glucose (p=0.01), BMI (p=0.01), and waist circumference (p<0.001), the latter having the strongest correlation with atherosclerosis burden (r=0.41, p<0.0001). ROC analyses established cutoffs for waist circumference identifying greater atherosclerosis burden in apparently healthy young adults. Conclusion: A simple low-cost office-based tool, waist circumference measurement improves prediction of early atherosclerosis in otherwise apparently healthy young adults.

대사증후군이 삶의 질에 미치는 영향

The purpose of this study was to investigate the effects of metabolic syndrome(MS) on quality of life(QoL) using the Korea National Health and Nutrition Examination Survey of 2013. We analyzed data for 4,890 adults, aged 19 year or older and provided the correct data about MS and QoL. MS was defined by the National Cholesterol Education Program-Adult Treatment Panel III with Korea-specific waist circumference cutoffs and QoL was measured by the EuroQol 5-dimension(EQ-5D). The prevalence of MS was 22.1% and high density lipoprotein(HDL)-cholesterol was the highest prevalence in MS components. The mean of EQ-5D index was significantly lower in subject with MS compared to subjects without MS. Among MS components, only higher waist circumference led to EQ-5D index decreasing and the regression coefficient was -0.018. In conclusion, we suggest the attention to QoL and intervention program for improving the QoL in subjects with MS.

Specific cut-off points for waist circumference and waist-to-height ratio as predictors of cardiometabolic risk in Black subjects: a cross-sectional study in Benin and Haiti.

PurposeWaist circumference (WC) and waist-to-height ratio (WHtR) are widely used as indicators of abdominal adiposity and the cut-off values have been validated primarily in Caucasians. In this study we identified the WC and WHtR cut-off points that best predicted cardiometabolic risk (CMR) in groups of African (Benin) and African ancestry (Haiti) Black subjects.MethodsThis cross-sectional study included 452 apparently healthy subjects from Cotonou (Benin) and Port-au-Prince (Haiti), 217 women and 235 men from 25 to 60 years. CMR biomarkers were the metabolic syndrome components. Additional CMR biomarkers were a high atherogenicity index (total serum cholesterol/high density lipoprotein cholesterol ≥4 in women and ≥5 in men); insulin resistance set at the 75th percentile of the calculated Homeostasis Model Assessment index (HOMA-IR); and inflammation defined as high-sensitivity C-reactive protein (hsCRP) concentrations between 3 and 10 mg/L. WC and WHtR were tested as predictors of two out of the three most prevalent CMR biomarkers. Receiver operating characteristic (ROC) curves, Youden’s index, and likelihood ratios were used to assess the performance of specific WC and WHtR cut-offs.ResultsHigh atherogenicity index (59.5%), high blood pressure (23.2%), and insulin resistance (25% by definition) were the most prevalent CMR biomarkers in the study groups. WC and WHtR were equally valid as predictors of CMR. Optimal WC cut-offs were 80 cm and 94 cm in men and women, respectively, which is exactly the reverse of the generic cut-offs. The standard 0.50 cut-off of WHtR appeared valid for men, but it had to be increased to 0.59 in women.ConclusionCMR was widespread in these population groups. The present study suggests that in order to identify Africans with high CMR, WC thresholds will have to be increased in women and lowered in men. Data on larger samples are needed.

Waist circumference, trunk and visceral fat cutoff values for detecting hyperinsulinemia and insulin resistance in children: the Healthy Growth Study.

Waist circumference, trunk and visceral fat cutoff values for detecting hyperinsulinemia and insulin resistance in children: the Healthy Growth Study.

Prevalence and correlates of metabolic syndrome and its components in elderly Korean adults

PurposeThis study examined the determinants of the prevalence of factors related to five components of metabolic syndrome in the elderly. MethodsThe study used raw data (2010–2012) from the Korea National Health and Nutrition Examination Survey-V. The 3971 study subjects were community-dwelling elderly adults aged over 65years. The criteria for the metabolic syndrome were based on those of the American Heart Association/National Heart, Lung and Blood Institute, and the waist circumference cutoff points for these factors were adapted from the standard suggested by the Korea Society for the Study of Obesity in 2005. ResultsThe overall prevalence of metabolic syndrome in Korean elderly adults was 43.6% (35.3% in men and 50.2% in women). Metabolic syndrome was 2.32 times more prevalent in women relative to men (95% confidence interval [CI]: 1.85–2.90, p<0.001), 1.26 times more prevalent in urban, relative to rural, residents (95% CI: 1.09–1.45, p=0.002), 1.43 times more prevalent in ex-smokers (95% CI: 1.14–1.80, p=0.002) and 1.45 times more prevalent in smokers (95% CI: 1.11–1.54, p=0.007) relative to nonsmokers, and 1.16 times more prevalent in sedentary, relative to active, subjects (95% CI: 1.02–1.32, p=0.028). ConclusionThe results indicated that the prevalence of metabolic syndrome in elderly Korean adults was high, suggesting that the prevention and management of metabolic syndrome in the elderly should be addressed via individual components.

Obesity among adult population of a rural coastal area in South India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Obesity is associated with cardiovascular diseases and has become the main public health issue in India. However, the prevalence of obesity in India varies widely. The aim of this study was to assess the prevalence of overweight and obesity among rural adults in a coastal area of South India.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The prevalence of overweight and obesity was assessed among individuals of 15 years and above living in a rural coastal area of Tamil Nadu in India.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among 207 adult participants, 69.1% were female. About one-fourth (23.7%) of the participants were in age group of 15-24 years and 67.2% participants were literate. About one-third (30%) of the adults were overweight. Obesity was present in 14% of the study participants (26% by using the Asian cut-offs). Using waist circumference and waist-hip ratio cut-offs, abdominal obesity was observed among 55% and 57% of the participants. Among females the central obesity was more common than males. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The prevalence of obesity in rural areas was high. There is need to implement community based programs to tackle the increasing obesity.

Body mass index and waist circumference are not good surrogate indicators of adiposity in psychogeriatric patients.

to assess the utility of body mass index (BMI) and waist circumference (WC) as surrogate indicators of adiposity with respect to the total body fat estimated with bioimpedance analysis in psychogeriatric patients. Anthropometric and hand-to-foot bioimpedance measurements were performed according to standard procedures in a sample of 128 psychogeriatric patients (87 males, 41 females). WC cutoffs proposed by the International Diabetes Federation were used to define abdominal obesity. Z-scores of fat and fat-free mass indices (Z-FMI and Z-FFMI) were calculated. Males with WC values below the cutoff were normal weight, and showed normal levels of FM and low FFM (Z-FFMI below 1.5 SD). Males with WC values above the cutoff were overweight, showed high levels of FM (Z-FMI: 1.34 SD) and a slight depletion of FFM (Z-FFMI: -0.59 SD). In females with WC values below the cutoff, BMI was close to 20 kg/m(2) and both FM and FFM were depleted (Z-FMI: -0.7 SD; Z-FFMI: -1.76 SD). In females with WC above the cutoff, the average BMI was 25.6 kg/m(2) , Z-FMI was 0.48 SD, and Z-FFMI was -0.56 SD. Our results indicate that it is necessary to establish age and sex-specific BMI and WC cutoffs, and also highlight the importance of focusing on body composition analysis to ensure an accurate nutritional diagnosis in older-adults and in psychogeriatric patients.

The prevalence of metabolic syndrome among low-income South Asian Americans.

The purpose of the present paper is to examine the prevalence of metabolic syndrome (MetS) and its components using the harmonized definition in an interviewed sub-sample of diverse, low-income, adult South Asians (SA) of both sexes residing in Maryland. We also wanted to derive a BMI cut-off value that was highly correlated with the recommended waist circumference (WC) that we could apply to a larger sample of SA Americans for whom only BMI values were available from clinic files. We also examined differences in MetS prevalence among various Asian ethnic groups (defined by country of origin) and the clustering pattern of their MetS components. Clinical data extraction on subjects (n 1002) and interviewees (n 401) were used in a cross-sectional study of SA Americans. Two community health centres in Montgomery and Baltimore County, MD, USA. SA adult males and females (n 1403) aged 20-68 years. The prevalence of MetS using harmonized WC cut-offs (90 cm in men and 80 cm in women) was 47% in men and 54% in women. Using a BMI of 23.0 kg/m2 gave a similar prevalence of MetS for males (48%) and females (47%). Of the five MetS components, the prevalence pattern differed among the ethnic groups, particularly for SA Indians. The prevalence of MetS in a diverse, low-income, SA American immigrant group using the harmonized definition was 51%. Derived lowered BMI cut-off of 23.0 kg/m2 should be used by clinicians in studies on SA when WC values are not available for detecting metabolic risk. SA Indians had a higher prevalence of abnormal TAG and blood glucose values compared with other SA, and therefore results for SA Indians should not be generalized to all SA ethnic groups.

Utility of Waist Circumference Percentiles vs. Adult Waist Circumference Cutoffs for Assessing Metabolic Risk in Overweight/Obese Adolescents

Background Waist circumference [WC] is difficult to use in pediatric clinical practice because there are no easy methods to convert measurements to percentiles [%tile]; use of adult cutoffs for adolescents could improve implementation. We assessed the utility of WC %tile 蠅90 and adult WC cutoffs (88 cm for women, 102 cm for men) in predicting high triglycerides [TG] (蠅150 mg/dl) and fasting blood glucose [FBG] (蠅100 mg/dl) and low HDL cholesterol [HDL] (<40 mg/dl men, <50 mg/dl women) in overweight/obese [OW/OB] adolescents. Methods: Cross-sectional data on WC (done in duplicate or triplicate if the first two measurements differed by >0.5 cm), TG, FBG and HDL were collected for 75 OW/OB participants (BMI %tile 蠅85) in 9th and 10th grade attending 4 urban high schools in the Southwest. Results: Participants were 52% female, 84% Hispanic and 55% obese (BMI %tile 蠅95), with an average age of 15.5 yrs. Based on 蠅90 WC %tile cutoff and adult cutoffs, respectively, 55% and 56% had high WC. Overall prevalence of high TG, high FBG and low HDL was 19%, 23% and 60%, respectively. The percentage of students with high TG, high FBG and low HDL, respectively, identified by the WC %tile 蠅90 vs. adult WC cutoffs was 79% vs. 54%, 62% vs. 64%, and 59% vs. 53%. At the 90th %tile WC cutoff, the sensitivity and specificity for high TG, high FBG and low HDL were 79% and 51%, 53% and 45% and 64% and 60%, respectively. Conclusions In this sample, the %tile-based cutoff was most useful for identifying teens with high TG; the adult cutoff performed very similarly for identifying teens with high FBG and low HDL. Funded by: NIH Grant R01 HL118734

Hypertriglyceridemic waist-to-height ratio phenotype: association with atherogenic lipid profile in Han adolescents.

The present study demonstrates that HWHtR phenotype is a simple marker for identifying adolescents with atherogenic lipid profile. Compared with HW phenotype, HWHtR phenotype is a non-age-dependent index with higher applicability to screen for cardiovascular risk factors in adolescents. • The hypertriglyceridemic waist phenotype is represented by the simultaneous presence of elevated serum triacylglycerol and increased waist circumference. Hypertriglyceridemic waist phenotype can identify adolescents with metabolic syndrome. But the cutoffs of waist circumference are age- and gender-specific standards and are less feasible for non-professional use. • The present study demonstrates that hypertriglyceridemic waist-to-height ratio phenotype is a simple marker for identifying adolescents with atherogenic lipid profile. Compared with hypertriglyceridemic waist phenotype, hypertriglyceridemic waist-to-height ratio phenotype is a non-age-dependent index with higher applicability to screen for cardiovascular risk factors in adolescents.

Prevalence of obesity and overweight, its clinical markers and associated factors in a high risk South-Asian population.

BackgroundObesity is a global epidemic, which is a risk factor for cardiovascular diseases and metabolic abnormalities. It is measured by body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), body fat (BF) distribution and abdominal fat mass, each having its own merits and limitations. Variability in body composition between ethnic groups in South-Asians is significant and may not be truly reflected by BMI alone, which may result in misclassification. This study therefore, aims to determine the frequency of obesity, body fat composition and distribution, in a high risk population of an urban slum of Karachi, Pakistan. This survey included 451 participants selected by systematic sampling who were administered pre-tested questionnaires on socio-demographics, diet and physical activity. Chi-square was used to determine the association between categorical variables and multiple linear regression was used for quantitative variables. A P value of less than 0.05 was considered significant.ResultsClassified by BMI, 29% study subjects were overweight and 21% obese (58.7% with central obesity). Body fat percent (BF%) classified 81% as overweight. Females were more obese (P 0.03) with higher prevalence of central obesity (P <0.001) and WHR (P 0.003) but with a lower muscle mass (P 0.001). Activity score and muscle mass showed inverse linear association with BF% whereas, WC, weight, BMI and WHR had a positive linear association with BF%. The relationship between BMI and BF% was quadratic with a weaker association at lower BMI. Adjusting for socio-demographic variables, BF%, weight, diastolic blood pressure (DBP), BMI and score on the diet questionnaire had a positive linear association with WC, while WC, WHR and BP had a positive linear association with BF%. BF%, muscle content and WC had a positive linear association with BMI.ConclusionConsidering lower cut-offs for South-Asians BMI and WC, this study showed a high prevalence of obesity among a sub-urban population of Karachi, which was even higher when BF% was measured. Considering the rising prevalence of non-communicable diseases, BF%, WC, WHR and BMI measurements are convenient and feasible means of identifying population at risk and hence addressing it through public awareness and early detection.Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-015-0044-6) contains supplementary material, which is available to authorized users.

Characterization of metabolic syndrome among diverse Hispanics/Latinos living in the United States: Latent class analysis from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Background/objectivesEmpirical investigation of the adequacy of metabolic syndrome (MetS) diagnostic criteria, and whether meaningful subtypes of MetS exist, is needed among Hispanics/Latinos. MethodsIn 15,825 US Hispanics/Latinos from HCHS/SOL, latent class analysis of MetS components (waist circumference, systolic and diastolic blood pressure, HDL cholesterol, triglycerides, glucose, and antihypertensive, lipid- and glucose-lowering medication use) was used to investigate (1) whether distinct subtypes of MetS could be identified, and how component levels differed between them, and (2) how identified subtypes related to covariates and cardiovascular disease (CVD) prevalence. ResultsTwo latent clusters emerged in both men (n=6317) and women (n=9508): one characterized by relatively healthy mean levels (Non-MetS cluster, 77.1% of men and 67.1% of women) and the other by clinically elevated mean levels (MetS cluster, 22.9% of men and 32.9% of women) across most MetS components. These clusters showed expected associations with covariates and CVD prevalence. Notable results suggest that (1) HDL cholesterol may poorly differentiate between US Hispanics/Latinos with and without MetS (mean=45.4 vs. 44.6mg/dL for men and 51.3 vs. 52.0mg/dL for women in the MetS vs. Non-MetS clusters, respectively) and (2) the NCEP-ATP III 88cm waist circumference cutoff for US females may not optimize diagnosis among Hispanic/Latino women (MetS cluster mean waist circumference=102.5cm). ConclusionsBeyond classification into having MetS or not, additional subtypes of MetS do not clearly emerge in US Hispanics/Latinos. Current diagnostic cutoffs for some components may not optimize MetS identification among this population.

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.

Sensitivity and Specificity Improvement in Abdominal Obesity Diagnosis Using Cluster Analysis during Waist Circumference Cut-Off Point Selection.

Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes during the construction of ROC curves for waist circumference (WC) cutpoint selection. Materials and Methods. A total of 1,902 subjects of both genders were selected from the Maracaibo City Metabolic Syndrome Prevalence Study database. Two-Step Cluster Analysis (TSCA) was applied to select metabolically healthy and sick men and women. ROC curves were constructed to determine WC cutoff points by gender. Results. Through TSCA, metabolic phenotype predictive variables were selected: HOMA2-IR and HOMA2-βcell for women and HOMA2-IR, HOMA2-βcell, and TAG for men. Subjects were classified as healthy normal weight, metabolically obese normal weight, healthy and metabolically disturbed overweight, and healthy and metabolically disturbed obese. Final WC cutpoints were 91.50 cm for women (93.4% sensitivity, 93.7% specificity) and 98.15 cm for men (96% sensitivity, 99.5% specificity). Conclusions. TSCA in the selection of the groups used in ROC curves construction proved to be an important tool, aiding in the detection of MOWN and MHO which cannot be identified with WC alone. The resulting WC cutpoints were <91.00 cm for women and <98.00 cm for men. Furthermore, anthropometry is insufficient to determine healthiness, and, biochemical analysis is needed to properly filter subjects during classification.

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.

Evaluation of plasma MMP-8, MMP-9 and TIMP-1 identifies candidate cardiometabolic risk marker in metabolic syndrome: results from double-blinded nested case–control study

AimsMatrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are dysregulated in metabolic syndrome (MetS) and associated with atherosclerosis and cardiovascular disease (CVD). Previous studies on the association between MMPs/TIMPs and MetS are controversial. We aimed to evaluate circulating MMP-8, MMP-9 and TIMP-1 in a group of MetS individuals and healthy controls to find the potential marker associated with MetS and its components. Methods243 MetS individuals participated in a nested case–control design, of whom 63 were excluded (study subjects for analysis n=180; 87 MetS cases, 93 controls). We employed the International Diabetes Federation criteria using national waist circumference cutoffs for case definition. Anthropometric and biochemical measurements were done using standard methods. ResultsPlasma MMP-8, TIMP-1, tumor necrosis factor-alpha (TNF-α), highly sensitive C-reactive protein (hs-CRP) and MMP-8/TIMP-1 ratio were significantly higher in MetS cases (P for all < 0.05). Each component of MetS except raised fasting plasma glucose positively correlated with MMP-8 and numbers of MetS components increased with higher MMP-8. In all regression models, MMP-8 was a significant predictor of MetS and in the final model the relationship persisted even after adjusting for pro-inflammatory cytokines hs-CRP and TNF-α (odds ratio=6.008, 95% confidence interval: 1.612–22.389, P=0.008). ConclusionStrong associations of MMP-8 with components of MetS in univariate, bivariate and multivariate models suggest plasma MMP-8 as a potential cardiometabolic risk marker for MetS. Higher MMP-8 in MetS is possibly mediated through mechanisms both dependent and independent of chronic low grade inflammation.

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.

The discriminatory performance of body mass index, waist circumference, waist-to-hip ratio and waist-to-height ratio for detection of metabolic syndrome and their optimal cutoffs among Iranian adults.

The superiority of either of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) for prediction of metabolic syndrome (MetS) is remained controversial in Asian population. The objective of this study was to compare the discriminative capacity of either of these measures in prediction of non-adipose components of MetS. In this population-based cross sectional study, 1000 representative samples of adults were recruited in Babol, northern Iran. The demographic, anthropometric measures and blood pressure were determined by standard method. Fasting plasma glucose (FPG), triglycerides (TG), total cholesterol (CHL), high density lipoprotein (HDL) cholesterol levels were measured with enzymatic methods by an auto analyzer. The presence of two or more any of four non-obese components were considered as MetS. The diagnostic accuracies (AUCs) of four different measures were rather similar. While AUC for BMI (AUC=0.684; 95% CI: 0.633, 0.736) slightly tended to be higher than that of WC (AUC=0.640; 95% CI: 0.587, 0.693) and WHtR (AUC=0.649; 95% CI: 0.596, 0.701) in men but the accuracy of WC (equivalently WHtR (AUC=0.708; 95% CI: 0.664, 0.751) is tended to be greater than that of BMI in women. The optimal cut-off value for WC was higher in men compared with women. Overall, BMI, WC and WHtR were significant predictors of MetS equally but WC (equivalently WHtR) was a better predictor than BMI and WHR in women. The optimal cut-offs of WC are lower compared with western population for men but not for women.

Natural course of metabolically healthy abdominal obese adults after 10 years of follow-up: the Tehran Lipid and Glucose Study.

This study aims to assess the natural course of metabolically healthy abdominal obese (MHAO) phenotype and determine the predictors of change in the metabolic status in this population over 10 years of follow-up. A total of 916 MHAO subjects from the Tehran Lipid and Glucose Study were followed for changes in their metabolic health status. Anthropometric and metabolic indices were measured at baseline and were compared between subjects with healthy and unhealthy metabolic conditions at the end of follow-up. Predictors of change in metabolic health were assessed in logistic regression models. National waist circumference cutoffs were used for definition of abdominal obesity. Metabolic health was defined as ⩽1 metabolic components of metabolic syndrome according to the Joint Interim Statement criteria. At the end of the follow-up, nearly half of the MHAO subjects lost their metabolic health and 42.1% developed metabolic syndrome by definition. Low high-density lipoprotein cholesterol, hypertriglyceridemia and homeostasis model assessment-insulin resistance at baseline were significant predictors of change in metabolic health condition. MHAO is a relatively unstable condition and a considerable percentage of these individuals will lose their metabolic health as time passes. Baseline metabolic characteristics may be useful predictors of this change and should be considered in the care of these individuals.