Waist circumference is a better predictor of metabolic syndrome than waist:hip ratio
Date
2013-09
Authors
Olugbemide, O.A
Olopade, O.B
Iwuala, S.O
Odeniyi, I.A
Fasanmade, O.A
Ohwovoriole, A.E
Journal Title
Journal ISSN
Volume Title
Publisher
Endocrinology and metabolism society of Nigeria
Abstract
BACKGROUND
The metabolic syndrome is a cluster of cardiovascular risk factors, each of which carries grave risk for fatal vascular events. Diagnosis of metabolic syndrome is made using clinical, anthropometric and biochemical parameters. Anthropometric indices are cost effective and readily accessible markers of metabolic syndrome especially in resource poor countries. Traditionally, waist circumference is the surrogate maker for central obesity but conventionally waist to height ratio is being projected. Recent report suggest that waist to height ratio may be a more sensitive correlate of metabolic syndrome than waist circumference.
Research Question
Is waist-to-height ratio a better predictor of metabolic syndrome than waist circumference in Type 2 diabetic Nigerians?
Objective
To determine if waist-to-height ratio is a better predictor of metabolic syndrome than waist circumference in Nigerians with Type 2 diabetes.
Methodology
This was a cross-sectional descriptive study.We studied 434 (171males and 263 females) Type 2 diabetic patients with metabolic syndrome over a 3months period.. Clinical and anthropometric indices were measured using standard technique and other tests such as fasting blood glucose, lipid profile were obtained.
The Controls were 75 apparently healthy patients recruited from the General Out Patient Department. They were made up of 34 males and 41females who do not have metabolic syndrome according to the World Health Organisation criteria.
Statistical analysis was done using SPSS version 20. Data were expressed as means (Standard Deviation), percentages and 95% Confidence Interval(CI). Comparisons were done using student t-test. The diagnostic performance of waist circumference and waist to height ratio was derived from Receiver-Operating Characteristic (ROC) analysis using the area under the curve (AUC). P-value < 0.05 was considered statistically significance.
Results
Five hundred and nine patients were recruited comprising 205 males and 304 females. The mean (SD) age was 56.3 years(±10.9). The mean (SD) for weight, waist and Hip circumferences, waist-height ratio and BMI were 77.5Kg(±15.2), 97.5cm(±11.89), 104.29cm(±11.2), 29.3(±5.5) respectively. Waist circumference was higher in males with metabolic syndrome 97.9(±11.4) than females with metabolic syndrome 97.1(±12.2), while waist to height ratio was higher in females 0.61 (±0.08) than males 0.58 (±0.07). Student T- test for female study participants with metabolic syndrome and the control subject was (t=9.1,p value<0.0001) while the male participant was (t =7.4,p value <0.0001). There were statistically significant difference between the means of both the females and males with metabolic syndrome and the control participant. The waist to height ratio derived for this study was 0.49 (95%CI 0.45 to 0.49) with a sensitivity(Sn) and specificity(Sp) in the female participants of 93.2% and 54% respectively, area under the ROC curve (AUC) (0.907(0.861-0.952)). Using a cut-off of 0.49 (95%CI 0.45 to 0.50) for waist to height ratio for the males(Sn93.6%;Sp42% ) ; AUC (0.907(0.861-0.952)) . Using the International Diabetes Federation cut-off value of 94cm for male waist circumference(Sn64.3%;Sp82.4%). Area under the ROC(0.868(0.811-0.925)). Using a cut-off of 80cm for female waist circumference (Sn91%;Sp62%). Area under the ROC (0.895(0.855-0.935)). Diagnotic accurancy for waist circumference was 79% while waist to height ratio was 81%.
Conclusion
From the study, it appears waist to height ratio is a better predictor of metabolic syndrome than waist circumference with a higher dianotic accurancy and sensitivity. However, larger studies will confirm this findings.
Description
Keywords
metabolic syndrome, anthropometric indices, Nigerians, waist circumference
Citation
Olugbemide OA, Olopade OB, Iwuala SO, Odeniyi IA, Fasanmade OA, Ohwovoriole AE. Waist circumference is a better predictor of metabolic syndrome than waist:hip ratio. Abstract PP/016 from 2013 book of abstracts, Endocrine and Metabolism Society of Nigeria