Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa

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 aime...

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Detalles Bibliográficos
Autores principales: Ekoru, K, Murphy, G A V, Young, E H, Delisle, H, Jerome, C S, Assah, F, Longo–Mbenza, B, Nzambi, J P D, On'Kin, J B K, Buntix, F, Muyer, M C, Christensen, D L, Wesseh, C S, Sabir, A, Okafor, C, Gezawa, I D, Puepet, F, Enang, O, Raimi, T, Ohwovoriole, E, Oladapo, O O, Bovet, P, Mollentze, W, Unwin, N, Gray, W K, Walker, R, Agoudavi, K, Siziya, S, Chifamba, J, Njelekela, M, Fourie, C M, Kruger, S, Schutte, A E, Walsh, C, Gareta, D, Kamali, A, Seeley, J, Norris, S A, Crowther, N J, Pillay, D, Kaleebu, P, Motala, A A, Sandhu, M S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880575/
https://www.ncbi.nlm.nih.gov/pubmed/29087388
http://dx.doi.org/10.1038/ijo.2017.240
Descripción
Sumario: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 24 181 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 81.2 cm (95% CI 78.5–83.8 cm) and 81.0 cm (95% CI 79.2–82.8 cm) 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 (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.