Appropriate Waist Circumference Cutoff Values for the Diagnosis of Metabolic Syndrome in Mexican American Adults

Abstract

Metabolic syndrome increases the risk of cardiovascular disease and diabetes. The International Diabetes Federation (IDF) recently proposed new criteria for the diagnosis of metabolic syndrome, which requires the presence of central obesity as measured by ethnic specific waist circumference (WC) cutoff values. Currently, no specific WC thresholds for diagnosis of central obesity in Hispanics are available. The objectives were to determine the appropriate gender specific WC thresholds for diagnosis of central obesity in Mexican American adults and to estimate the prevalence of metabolic syndrome using IDF definition with and without the modified WC in this population. Data from 3265 Mexican American adults aged 20-80 years who participated in the National Health and Nutrition Examination Survey 1999-2006 were used. The prevalence of metabolic syndrome was compared using IDF criteria with and without the modified waist circumference. Receiver operating characteristic curve analysis suggested that yielding at least 80% sensitivity, the WC value of 90 cm in both genders was more appropriate in predicting the presence of two or more metabolic syndrome risk factors in this population. Based on this cutoff, there was 34% reduction in the prevalence of central obesity in women (82.5% to 54.2%). The age adjusted prevalence of metabolic syndrome decreased from 58.4 to 48.2%. The metabolic syndrome was more common among Mexican American men than women (55.8% in men versus 37.8% in women, P =0.0003). Our findings provided a practical guidance in the assessment and screening of central obesity and metabolic syndrome in Mexican Americans.