Waist circumference, body mass index and waist to hip ratio for prediction of the metabolic syndrome in Chinese

Received 5 September 2008; received in revised form 21 October 2008; accepted 10 November 2008. published online 02 February 2009.

Abstract

Background and aims

To explore the ability of waist circumference (WC), body mass index (BMI) and waist to hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (MetS) among individuals aged 18–85 in North China.

Methods and results

This study is a cluster sample survey of 101,510 individuals, complete data are 75,788 subjects, 59,874 males and 15,914 females. Their ages were 51.9±12.7 years (males) and 48.7±11.5 years (females). Receiver operating characteristic (ROC) analysis was used to examine discrimination and find optimal cut off values of WC, BMI and WHR to predict two or more non-adipose components of MetS. The area under the ROC curve (AURC) for WC (0.694) and BMI (0.692) in females showed no difference. In males BMI (0.657) had a better discrimination than WC (0.634). WHR was weaker in both sexes. The optimal cut off value of WC in males (86.5cm) was higher than in females (82.1cm); and that of BMI was about 24kg/m2 in both genders. The optimal cut off values of WC, BMI, and WHR, increased with age in both sexes.

Conclusions

BMI and WC are more useful than WHR for predicting two or more non-adipose components of MetS. Cut off values for WC in males, and those of BMI and WHR in both sexes are lower than that in present MetS criteria; WC in females is slightly higher. Cut off values of WC, BMI and WHR were increased with age in the Chinese.

Keywords: Waist circumference, Body mass index, Waist to hip ratio, Metabolic syndrome, Receiver operating characteristic

Abbreviations: WC, waist circumference, BMI, body mass index, WHR, waist to hip ratio, MetS, metabolic syndrome, ROC, receiver operating characteristic, AURC, the area under the ROC curve, IDF, International Diabetes Federation, WHO, the World Health Organization, WSR, waist to stature ratio

a Department of Epidemiology and Biostatistics, Peking University Health Science Center, Key Laboratory of Epidemiology of Peking University, Ministry of Education, China. 38 Xue Yuan Road, Hai Dian District, Beijing 100191, China

b Kailuan Hospital Affiliated to North China Coal Medical College, Tangshan 063000, China

c School of Population Health, The University of Auckland, New Zealand

Corresponding author. Tel.: +86 10 8280 1189; fax: +86 10 8280 1518.

PII: S0939-4753(08)00227-5

doi:10.1016/j.numecd.2008.11.006

5 of 11