Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in Sub-Saharan Africa.
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Authors
Gray, William K.
Walker, Richard
Issue Date
2017
Type
Article
Language
en
Keywords
obesity , cardiometabolic disease , clinical risk prediction
Alternative Title
Abstract
Background: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk.
Methods: We used individual level cross-sectional data on 24181 participants aged ?15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC.
Results: The optimal WC cut-point was 81.2cm (95% CI 78.5-83.8?cm) and 81.0cm (95% CI 79.2-82.8cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63-65) than in men (53%, 95% CI 51-55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4-2.9, for men and 2.2, 95% CI 2.0-2.3, for women).
Conclusion: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (?81.2cm) than current guidelines (?94.0cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.
Description
Citation
Ekoru, K., Murphy, G., Young, E. et al. Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa. International Journal of Obesity; 42 : 487–494.
Publisher
License
Journal
International Journal of Obesity
Volume
Issue
ISSN
1476-5497