2013, Number 1
<< Back Next >>
Rev Cub Med Mil 2013; 42 (1)
Estimated cutoff abdominal circumference of metabolic syndrome diagnosis criterion
Remón PI, González SOC, Arpa GÁ
Language: Spanish
References: 33
Page: 29-38
PDF size: 150.84 Kb.
ABSTRACT
Introduction: waist circumference is an atherogenic risk factor and a criterion for metabolic syndrome diagnosis. Various international organizations have recommended that the cutoff point of this circumference to define that the abovementioned syndrome would be contextually determined in each country. However, in Cuba, there are no studies aiming this end.
Objective: to estimate the cutoff point of waist circumference for the diagnosis of this syndrome in a population group.
Methods: an observational, cross-sectional study was conducted in 703 patients at the Holguin Granma region. Variables defining the metabolic syndrome according to the modified criteria of Adult Treatment Panel III were taken. The curves of Receiver Operator Characteristics (ROC) were obtained for each sex at different values of the circumference to discriminate those subjects with two or more diagnostic criteria in this syndrome. The cutoff point was chosen according to Youden rate.
Results: the cutoff abdominal circumference obtained was 97 cm in men and 85 cm in women, with 55% sensitivity and 91% specificity in men, and 87 and 72% respectively in women.
Conclusions: in our context, the cutoff point of abdominal circumference to be used for diagnosing of metabolic syndrome is 97 cm in men and 85 cm in women.
REFERENCES
Arpa A, González O. El síndrome metabólico (Editorial). Revista Cubana de Medicina Militar. 2009;38(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572009000100001&lng=es
Pischon T, Boeing H, Hoffmann K. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105-20.
Wang Y, Rimm EB, Stampfer MJ. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr. 2005;81:555-63.
Leitzmann MF, Moore SC, Koster A. Waist Circumference as Compared with Body-Mass Index in Predicting Mortality from Specific Causes. PLoS ONE. 2011; 6(4):18582.
Feller S, Boeing H, Pischon T. Body mass index, waist circumference and the risk of type 2 diabetes mellitus implications for routine clinical practice. Dtsch Arztebl Int. 2010;107(26):470-6.
Berentzen TL, Jakobsen MU, Stegger JG. Changes in waist circumference and the incidence of acute myocardial infarction in middle-aged men and women. PLoS ONE. 2011;6(10):e26849. doi:10.1371/journal.pone.0026849.
Lean ME. Waist circumference as a measure for indicating need for weight management. BMJ. 1995;311:158-61.
Expert panel on the identification evaluation and treatment of overweight and obesity in adults. Executive summary of the clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults. Arch Intern Med 1998;158:1855-67.
Alberti KG, Eckel RH, Grundy SM. Harmonizing the metabolic syndrome. A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society and International Association for the Study of Obesity. Circulation. 2009;120:1640-5.
Klein S, Allison DB, Heymsfield SB. Waist circumference and cardiometabolic risk: a consensus statement from shaping America's health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition and the American Diabetes Association. Am J Clin Nutr. 2007; 85:1197-202.
Grundy SM, Cleeman JI, Daniels SR. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation. 2005;112:2735-52.
Perkins NJ, Schisterman EF. The inconsistency of "optimal" cut points obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670-5.
Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3:32-5.
Isomaa Bo, Almgren P, Tuomi T. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24(4):683-9.
Rielly MP, Rider DJ. The metabolic syndrome: more than the sum of its parts? Circulation. 2003;108:1546-51.
Balkau BJ, Vernay M, Mhamdi L. The frequency and incidence of the NCEP metabolic syndrome in the French DESIR study. The European Association for the Study of Diabetes. Abstract Volume of 38th Annual Meeting; 2002;15:37.
Athyros VG, Boulokus VI, Pehlivanidis AN. The prevalence of the metabolic syndrome in Greece: the MetS Greece Multicentre Study. Diabetes Obes Metab. 2005;7(4):397-405.
Álvarez León EE, Ribas Barba L, Serra Majem L. Prevalencia del síndrome metabólico en la población de la comunidad Canaria. Med Clin (Barc). 2003; 120(5):172-4.
del Río A, Ferreira IJ, Casanovas JA. Temas de actualidad en Cardiología preventiva: el síndrome metabólico. Rev Esp Cardiol. 2005;5:13-23.
Banduceau B, Gaigts F, Bordier L. Epidemiology of the metabolic syndrome in 2 045 French military personnel (EPIMIL study). Diabetes Metab. 2005;31:353-9.
Eckel RH, Grundy SM, Zimmet PL. The metabolic syndrome. Lancet. 2005;365:1415-28.
Escobedo J, Schargrodsky H, Champagne B. Prevalence of the Metabolic Syndrome in Latin America and its association with sub-clinical carotid atherosclerosis: the CARMELA cross sectional study. Cardiovascular Diabetology. 2009;8:52-61.
Bays HE, González-Campoy JM, Schorr AB. What men should know about metabolic syndrome, adiposopathy and 'sick fat'. Int J Clin Pract. 2010;64(13):1735-9.
Bays HE, González-Campoy JM, Bray GA. Pathogenic potencial of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity. Expert Rev Cardiovasc Ther. 2008;6:343-68.
Guilherme A, Virbasius JV, Puri V. Adipocyte dysfunctions linking obesity to insulin resistance and type 2 diabetes Nat Rev Mol Cell Biol. 2008;9(5):367-77.
Evans J, Micklesfield L, Jennings C. Diagnostic ability of obesity measures to identify metabolic risk factors in South African women. Metabol Syndr Relat Dis. 2011;9(5):353-60.
Hara K, Matsushita Y, Horikoshi M. A proposal for the cutoff point of waist circumference for the diagnosis of metabolic syndrome in the Japanese population. Diabetes Care. 2006;29:1123-4.
Delavari A, Frouzanfar MH, Alikhani S. First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East. Diabetes Care. 2009;32(6):1092-7.
Lu Q, Xie Z, Zhang H. Evaluation of the appropriate diagnostic threshold of waist circumference for the cardiometabolic syndrome in Chinese uygur adults. JCMS. 2009 doi: 10. 1111/j.1559-4572.2008.00045.x.
Kim HI, Kim JT, Yu SH, et al. Gender differences in diagnostic values of visceral fat area and waist circunference for predicting metabolic syndrome in Koreans. J Korean Med Sci. 2011;26:906-13.
Ibrahim MM, Elamragy AA, Girgis H. Cut off values of waist circumference & associated cardiovascular risk in Egyptians. BMC Card Dis. 2011;11:53. Available in: http://www.biomedcentral.com/1471-2261/11/53
Tulloch-Reid MK, Ferguson TS, Younger MOM. Appropriate waist circumference cut points for identifying insulin resistance in black youth: a cross sectional analysis of the 1986 Jamaica birth cohort. Diabetol Metab Syndr. 2010;2:68. Available in: http://www.dmsjournal.com/content/2/1/68
Pratyush DD, Tiwari S, Singh S. Waist circumference cut off and its importance for diagnosis of metabolic syndrome in Asian Indians: A preliminary study. Indian J Endocrinol Metab. 2012;16(1):112-5.