Optimal Cutoffs of Cardiometabolic Risk for Postmenopausal Korean Women

ABSTRACT

PURPOSE: The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO). METHODS: The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index. RESULTS: Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC) 0.687, sensitivity 61.7%, specificity 68.9%], 0.87 (AUC 0.660, sensitivity 64.7%, Specificity 60.2%) for MetS and 77.4 cm (AUC 0.655, sensitivity 65.6%, specificity 57.8%), 0.86 (AUC 0.680, sensitivity 67.0%, specificity 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC 0.838, sensitivity 71.5%, specificity 79.6%) and 1.59 (AUC 0.725, sensitivity 65.9%, specificity 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC 0.773, sensitivity 73%, specificity 71.9%) and for MO was 1.17 (AUC 0.713, sensitivity 64.5%, specificity 69.2%). CONCLUSIONS: For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.