RELATIVE SIGNIFICANCE OF WAIST CIRCUMFERENCE, BODY MASS INDEX AND WAIST-HIP RATIO AS PREDICTORS OF THE METABOLIC SYNDROME IN AN APPARENTLY HEALTHY NIGERIAN POPULATION

Objective: Body weight is a predictive factor of metabolic syndrome (MS). The usefulness of different indices of body weight as predictors of MS needs to be evaluated.

Aims: To evaluate the predictive potentials of waist circumference (WC), body mass index (BMI), and waist-hip ratio (WHR) as predictors of MS in an apparently healthy Nigerian population.

Materials and Methods: Data from previous studies were analyzed. Measurements were made using standard procedures. Odds ratio, (OR), sensitivity, specificity and positive predictive value (PPV) were calculated using standard formulae.

Results: The ATP111 cut-off point for WC >102cm/>88cm, gave OR 19.8, sensitivity 81.3%, specificity 82% PPV 58% and prevalence of 23.4 in the male-plus female group. Substituting ≥93cm for both men and women values were: 31.9, 90.7, 76.6, 56.5 respectively and prevalence of 16.4 %. In the males-only group, the values obtained using >102cm were 44.5, 56.5%, 97.2% and 76% respectively. Substituting ≥93cm gave the following values 59.5, 94.3%, 78.3% and 54.1% respectively. In the female group, WC >88cm recorded the following values; 18.9, 91.2, 64.5, 54.7 for OR, sensitivity, specificity, PPV respectively. Substituting ≥93cm 22.3, 88.2, 74.8, 58.4 respectively.

Conclusions: WC may be a better predictor of MS in the study population than either BMI or WHR. There is the need to adjust the ATP111 cut-off point for WC especially for men, >102cm, to improve its predictive potentials. Since there were no significant sex-specific differences in the WC of the study population, the same cut-off point, ≥93cm, may be used for both men and women.