Waist circumference cutoff and its importance for diagnosis of metabolic syndrome in Asian Indians: A preliminary study

BACKGROUND: There is inconsistency in accepting waist circumference (WC) as mandatory and also regarding its significance for diagnosis of metabolic syndrome (MetS) for different populations. AIM: To study the association of individual parameters of MetS with WC cutoffs suitable for South Asian Indians. MATERIALS AND METHODS: From an ongoing hospital-based study on MetS as per the criteria of diagnosis of modified NCEP ATP III, 713 subjects having a minimum three of the four parameters, i.e., dyslipidemia [low high density lipoprotein (HDL), high triglycerides], dysglycemia and hypertension, without regard to cutoffs of WC, were included in the present study. RESULTS: Receiver operator characteristic curve analysis of WC cut-off points for males was 90 cm with a sensitivity and specificity of 71% and 96%, respectively, and for females was 85 cm with a sensitivity and specificity of 86% and 93%, respectively, associated with the risk factors of MetS. Multiple logistic regression analysis for low density lipoprotein (LDL) cholesterol concentration of ≥3.38 mmol/l showed an odds ratio of 5.03 (95% CI = 1.29–19.5) in males and 3.17 (95% CI = 1.14–8.76) in females which was statistically significant (P < 0.02); in addition to higher WC, higher level of triglyceride (P ≤ 0.0001) and lower level of high density lipoprotein cholesterol (P ≤ 0.02) were observed. CONCLUSION: This study suggests that WC of 90 cm in males and 85 cm in females should be a mandatory criterion of MetS in our subset of population. LDL may be considered one of the components of MetS along with the currently defined WC cutoffs.