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

ABSTRACT

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