Abstract:
The waist circumference cut-off point for diagnosing metabolic syndrome in
Sub-Saharan Africa is based on standards established for European populations.
The purpose of this study was to determine the prevalence of metabolic
syndrome and other related disorders and to determine the waist circumference
cut-off point that effectively discriminates between African women with
and without metabolic syndrome. Initially, the study participants with metabolic
syndrome were identified using the National Cholesterol Education Program
- Third Adult Treatment Panel criteria, which was subsequently adapted to
the International Diabetes Federation definition. According to the National
Cholesterol Education Program - Third Adult Treatment Panel definition, metabolic
syndrome is present if at least three of the following criteria are met: Triglycerides
≥1.7 mmol/L, High-density lipoprotein cholesterol <1.29 mmol/L, Glucose
≥5.6 mmol/L, Systolic Blood Pressure ≥ 130 mmHg, or Diastolic Blood
Pressure ≥ 85 mmHg. The prevalence of metabolic syndrome and obesity (body
mass index ≥30 kg) were 19% and 30%, respectively.
The optimal waist circumference for diagnosing metabolic syndrome was obtained
using receiver operating characteristic curve analysis and was found
to be 88 cm. Machine learning methods, including logistic regression, linear
discriminant analysis and random forest were employed to further validate
the cut-off point. The 88 cm cut-off point demonstrated superior performance
compared to the European 80 cm cut-off pint, based on prediction accuracy,
specificity and positive predictive value. The study highlights how important
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it is to have population-specific cut-off points for correctly diagnosing metabolic
syndrome in order to reduce the risk of misdiagnosis and related complications.
The findings advocate for using the 88 cm cut-off point, which differs with the
recommended cut-off point of 80 cm. This is a as a quick and cost-effective measure
for identifying obesity, potentially improving public health interventions
for African populations.
