• Vol. 42 No. 5, 241–245
  • 15 May 2013

Waist Circumference is a Potential Indicator of Metabolic Syndrome in Singaporean Chinese



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Introduction: Metabolic Syndrome (MetS) is associated with cardiovascular morbidity and mortality. Studies proposed that waist circumference (WC) and body mass index (BMI) are good indicators of MetS. In this study, we examined and compared the predictive utility of clinical measures such as WC, blood pressure and BMI and determined the cutoff points in which these measures are most reliable in identifying MetS in Singaporean Chinese.

Materials and Methods: Two hundred and forty-four subjects aged between 21 and 50 years of Chinese ethnicity were recruited into the study. Sociodemographic, height, weight and blood pressure information were obtained. High-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and glucose levels were evaluated. Presence of MetS was examined according to American Heart Association (AHA)/National Heart, Lung and Blood Institute (NHLBI) guidelines. Predictive utility of BP, WC and BMI was examined using receiver operating curve and discriminant indices were determined accordingly.

Results: Forty-one (16.8%) subjects were identified to have MetS. Our analysis revealed that waist circumference was most accurate in identifying MetS (area under the curve (AUC) = 0.88, 95% confidence interval (CI), 0.83 to 0.93, P <0.001) followed by BMI (AUC = 0.84, 95% CI, 0.77 to 0.91, P = 0.035), systolic BP (AUC = 0.83, 95% CI, 0.76 to 0.90, P = 0.036) and diastolic BP (AUC = 0.80, 95% CI, 0.71 to 0.88, P = 0.042). Waist circumference cut-off values of >92.5 cm in males and >86.5 cm in females were found to be most sensitive and specific in discriminating MetS.

Conclusion: Our finding has immediate and significant clinical implications as WC can be easily obtained. However, as the study included only Singaporean Chinese, findings cannot be generalised for other ethnic groups.

Metabolic Syndrome (MetS), as characterised by increased visceral adiposity, hyperglycaemia, hypertension and hyperlipidaemia has been consistently reported to be a risk factor for the development of type 2 diabetes and cardiovascular diseases and contribute significantly to the increase prevalence of cardiovascular mortality. In Singapore, the prevalence of MetS, depending on the criteria adopted, had been reported to range from 17.7% to 26.2%.4,5 The criteria set by the American Heart Association
(AHA)/National Heart, Lung and Blood Institute (NHLBI) has been suggested to be most sensitive in predicting MetS in the Singaporean population6 and had been associated
with a 3-fold increase in cardiovascular mortality.

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