New proposed cut-off of waist circumference for central obesity as risk factor for diabetes mellitus: Evidence from the Indonesian Basic National Health Survey

Background Waist circumference (WC) measurement is practical to define central obesity. However, WC cut-off point might be differ based on different race or ethnicity. This study aims to analyze the optimal WC cut-off point to identify T2DM risk among Indonesian population. Method We analyzed the secondary data of national based cross-sectional study of the Indonesian Basic National Health Research 2013, comprising 24,660 adults aged ≥ 18 years who were assessed for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). The new proposed cut-off point for WC was calculated using ROC curve analysis and Youden index. The odds ratio of having T2DM was calculated using logistic regression analysis. Results Increased WC was associated with worsening dysglycemia status among men and women (p<0.001). The optimal cut-off point of WC for detecting T2DM from ROC analysis was 76 for men and 80 for women. Based on this WC cut-off point, the odds ratio for having T2DM was 1.64 [95% CI 1.45–1.86, p<0.01] for men and 1.90 [95% CI 1.71–2.11 p<0.01] for women. Conclusion The newly proposed WC cut-off point of 76 for men and 80 women can be used to screen the risk of T2DM among Indonesian population.

Download Full-text

Neck Circumference as an Anthropometric Indicator of Central Obesity in Patients with Prediabetes: A Cross-Sectional Study

BioMed Research International ◽

10.1155/2019/4808541 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Thunyarat Anothaisintawee ◽

Nakarin Sansanayudh ◽

Sangsulee Thamakaison ◽

Dumrongrat Lertrattananon ◽

Ammarin Thakkinstian

Keyword(s):

Waist Circumference ◽

Central Obesity ◽

Cross Sectional Study ◽

Neck Circumference ◽

Youden Index ◽

Sectional Study ◽

Roc Curve Analysis ◽

Cross Sectional ◽

Pairwise Correlation ◽

Glucose Levels

Measurement of waist circumference has substantial variability and some limitations, while neck circumference is a simple and reliable anthropometric measure. This study aimed to assess the association between neck circumference and waist circumference and to identify the best cutoff of neck circumference that could predict central obesity in prediabetic patients. This cross-sectional study included adult patients with prediabetes, defined as having fasting plasma glucose levels ranging from 100 to 125 mg/dL or HbA1c ranging from 5.7 to 6.49%, who visited the outpatient clinic of Family Medicine Department, Ramathibodi Hospital, Thailand, during October 2014 and March 2016. Neck circumference was measured from the level just below the laryngeal prominence perpendicular to the long axis of the neck. Central obesity was defined as having waist circumference measurements greater than 90 and 80 cm for males and females, respectively. The correlation between neck circumference and waist circumference was explored by applying pairwise correlation coefficient. Receiver operating characteristic (ROC) curve analysis was performed and Youden index equal to “sensitivity – (1-specificity)” was calculated. Neck circumference that yielded the maximum Youden index was determined as the optimal cutoff point for prediction of central obesity. There were 1,534 patients eligible for this study. After adjusting for covariables, neck circumference was found to be significantly associated with waist circumference in both females and males, with β-coefficients of 1.01 (95% CI: 0.83, 1.20) and 0.65 (95% CI: 0.46, 0.85), respectively. After applying the ROC analysis, neck circumferences ≥ 32 cm in females and ≥ 38 cm in males were determined as the best cutoff values to predict central obesity. Neck circumference is strongly correlated with waist circumference in prediabetics and should be considered as an alternative to the waist circumference measurement in screening for central obesity.

Download Full-text

The Relationship Of Waist Circumference And Hypercholesterolemia Incidence In Patient With Hypertension in Tegal Gundil Public Health Center at Bogor City

Jurnal Kesehatan Komunitas ◽

10.25311/keskom.vol5.iss1.335 ◽

2019 ◽

Vol 5 (1) ◽

pp. 34-43

Author(s):

Siti Hana ◽

Ratu Ayu Dewi Sartika

Keyword(s):

Heart Disease ◽

Waist Circumference ◽

Central Obesity ◽

Secondary Data ◽

Blood Cholesterol ◽

Cross Sectional ◽

Hypertensive Patients ◽

Multivariate Tests ◽

Relationship Of ◽

The Relationship

Hypertension and hypercholesterolemia are the causes of coronary heart disease (CHD) so that the presence of hypercholesterolemia in patients with hypertension will increase the risk of CHD. Central obesity describes the accumulation of fat in the stomach which can lead to abnormalities in the amount of lipids in the blood, when it occurs in patients with hypertension can lead to progression of the occurrence of high blood cholesterol and the risk of causing atherosclerosis and heart disease. The purpose of this study was to determine the relationship of waist circumference and other factors with the incidence of hypercholesterolemia in patients with hypertension. This research is a quantitative study through secondary data with Cross Sectional design. According to the results of multivariate tests with multiple logistic regression, there was a relationship between waist circumference, gender and age after being controlled by physical activity variables. Gender as a risk factor most associated with the incidence of hypercholesterolemia with a risk 8.5 times higher in women than men, then carried out waist circumference stratification test by sex in hypertensive patients with cases of central obesity found a significant relationship that women with central obesity have a risk of experiencing hypercholesterolemia as much as 5.5 times compared to central obesity in men with a value of p <0.05. There is a waist circumference relationship with the incidence of hypercholesterolemia in women who are central obesity more at risk of developing hypercholesterolemia than central obesity in men. Keywords: Hypercholesterolemia, waist circumference, hypertensive patients

Download Full-text

Neck Circumference, a Novel Predictor of Overweight/ Obesity in School Children in Pokhara

Med Phoenix ◽

10.3126/medphoenix.v5i1.31396 ◽

2020 ◽

Vol 5 (1) ◽

pp. 32-39

Author(s):

Manisha Maskey ◽

KK Dutta Gupta ◽

Meraj Ahmed

Keyword(s):

Waist Circumference ◽

School Children ◽

Good Predictor ◽

Central Obesity ◽

Characteristic Curve ◽

Cross Sectional Study ◽

Neck Circumference ◽

Anthropometric Parameters ◽

Cross Sectional ◽

High Bmi

Background: Calculating BMI in an individual is a standard anthropometric procedure to estimate overweight/obesity. But it has been observed to be a bad predictor of central obesity. On the other hand, waist circumference, in many studies, has been found to be a good predictor of central obesity but not so frequently used because of tendency to vary throughout the day. In the recent years, NC has been found to have a good correlation with both BMI and WC. The aim of this study was to find out whether neck circumference is a good predictor of Overweight/Obesity or not. Methods: This was a cross sectional study carried out among the school children, aged 12 to 15 years, in Pokhara city, Nepal. In total, 408 students, 238 males and 170 females were screened. Anthropometric markers of obesity measured: included body mass index (BMI), waist circumference (WC), and compared with neck circumference (NC) of the same subjects. Pearson’s correlation test was used to see the correlation between NC with BMI and WC, and receiver operating characteristic curve analysis was used to determine the best cut off value of neck circumference in predicting high BMI. Results: Among 408 students, 238 (58.3%) were male and 170 (41.7%) were female. Among them 37 (9.1%) were overweight and 32 (7.8%) were obese. All the anthropometric parameters were significantly higher in cases, except height in male, than in controls. NC was significantly correlated with age, BMI, and waist circumference in both boys and girls. The best cut-off value of neck circumference by ROC to identify boys with a high BMI was 29.5 with sensitivity of (76%), specificity (54%), and for girls was 28.5 with sensitivity of (97%), specificity (48%). Conclusion: Statistically significant positive correlation was found between NC with BMI and WC. The value of NC as a screening tool has been found comparably lower in compare to WC.

Download Full-text

Evaluation of anthropometric parameters of central obesity in Pakistani children aged 5–12 years, using receiver operating characteristic (ROC) analysis

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0193 ◽

2018 ◽

Vol 31 (9) ◽

pp. 971-977 ◽

Cited By ~ 5

Author(s):

Muhammad Asif ◽

Muhammad Aslam ◽

Saima Altaf

Keyword(s):

Central Obesity ◽

Diagnostic Performance ◽

Roc Analysis ◽

Operating Characteristics ◽

Obese Children ◽

Roc Curve Analysis ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Anthropometric Parameter ◽

Receiver Operating

Abstract Background Different anthropometric parameters have been proposed for assessing central obesity in children, but the ability of these anthropometric parameters to correctly measure central obesity in Pakistani children is questionable and needs to be assessed. The aims of this investigation were to examine the diagnostic performance of anthropometric parameters as indicators of central obesity in Pakistani children as measured by waist circumference (WC) and to determine the sex-specific best cut-off values for these parameters that would identify obese children. Methods Anthropometric measurements – height, weight, WC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), conicity index (CI) and neck circumference (NC) – from a cross-sectional sample of 5964 Pakistani children aged 5–12 years were analyzed. Receiver operating characteristics (ROC) analysis was used to examine the diagnostic performance and to determine the optimal cut-off point of each anthropometric parameter for identifying centrally obese children. Results It was found that WC had a significantly positive correlation with all studied anthropometric parameters. The ROC curve analysis indicated that all the parameters analyzed had good performance but WHtR had the highest value of the area under the curve (AUC). Optimal cut-off points associated with central obesity for boys and girls were, respectively, 0.47 and 0.48 for WHtR, 1.20 and 1.23 for CI, 0.96 and 0.96 for WHR and 26.36 and 26.54 cm for NC. Conclusions The sex-specific cut-off points for WHtR, CI, WHR and NC can be used to detect central obesity in Pakistani children.

Download Full-text

Gender Differences in Cardiometabolic Risk Factors in Metabolically Healthy Normal Weight Adults with Central Obesity

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-0043-119877 ◽

2017 ◽

Vol 126 (05) ◽

pp. 309-315

Author(s):

Katarína Šebeková ◽

Melinda Csongová ◽

Radana Gurecká ◽

Zora Krivošíková ◽

Jozef Šebek

Keyword(s):

Blood Pressure ◽

Waist Circumference ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Central Obesity ◽

Cross Sectional Study ◽

Normal Weight ◽

Cross Sectional ◽

Fasting Plasma ◽

Metabolically Healthy

AbstractWe investigated whether metabolically healthy normal weight adults with central obesity display worse cardiometabolic profile compared with their centrally lean counterparts. This retrospective, cross-sectional study, comprised 1 135 subjects (64% females) aged 18-to-81 years, presenting ≤2 components of metabolic syndrome. They were classified as centrally lean (waist-to-height ratio (WHtR)<0.5 and waist circumference<80 cm in females and<94 cm in males) or presenting central obesity (WHtR ≥0.5, regardless of waist circumference). Data on blood pressure, glucose homeostasis, lipid profile, renal function, high-sensitive C-reactive protein (hsCRP), uric acid, adiponectin, leptin, and soluble receptor for advanced glycation end products were compared between the groups, separately in males and females. 5.7% of males and 6.9% of females presented WHtR ≥0.5. Compared with centrally lean subjects, those with central obesity had higher BMI-adjusted fasting plasma glucose (p<0.001), and leptin levels (p<0.05); females also presented higher blood pressure (p<0.001), while males had higher hsCRP concentrations (p=0.021). These changes associated with significantly higher BMI-adjusted odds to present fasting plasma glucose >5.6 mmol/l in both genders, higher odds to present hsCRP >3 mg/l in males, and those to present elevated blood pressure in females. Our analysis suggests that in metabolically healthy normal weight subjects WHtR ≥0.5 might indicate “early increased health risk”.

Download Full-text

Sensitivity and specificity of waist circumference as a single screening tool for assessment of overweight and obesity

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20174839 ◽

2017 ◽

Vol 4 (11) ◽

pp. 4254

Author(s):

Anubrata Karmakar ◽

Shobhit Garg ◽

Aparajita Dasgupta ◽

Bobby Paul ◽

Swanya P. Maharana

Keyword(s):

Waist Circumference ◽

Sensitivity And Specificity ◽

Roc Curve ◽

Screening Tool ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Public Health Perspective ◽

Cross Sectional

Background: Generalised and central obesity are established risk factors for metabolic syndrome and cardiovascular diseases. Easy assessment of overweight or obesity is the need of the hour from public health perspective. Waist circumference (WC) can be a simple screening tool for identifying overweight individuals since measuring WC is simple, inexpensive, less time consuming, convenient for self-monitoring and needs no complicated calculation as BMI.Methods: A community based cross-sectional study was conducted in January-February 2017 among 338 adults, in a village of Singur Block, West Bengal. Height, weight and WC were measured for each subject. Receiver Operating Characteristic (ROC) curve analysis was used to estimate the cut-off values of WC.Results: The sensitivity and specificity of WC ≥90 centimeters for men for identifying overweight (BMI ≥25) were 78.8% and 75.6% respectively, whereas those of WC ≥80 cm for women were 80.3% and 44% respectively. ROC curve analysis revealed good diagnostic accuracy at 88.5 cm for WC cut-off for men (area under curve (AUC) 0.854, sensitivity 86.5%, specificity 67.6%) and fair accuracy (AUC 0.744, sensitivity 80.3%, specificity 44%) for WC cut-off for 80 cm for women.Conclusions: This study shows, WC can be used for screening of overweight individual infield practice as measuring tape is inexpensive and easy-to-carry compared to a weighing scale. More research may be done on larger sample size to establish an optimal WC cut-off value for Indian population.

Download Full-text

Correlation of Ghrelin and Obestatin with Waist Circumference in Central Obese Men

The Indonesian Biomedical Journal ◽

10.18585/inabj.v3i2.144 ◽

2011 ◽

Vol 3 (2) ◽

pp. 133

Author(s):

Widya Kurniawati ◽

Marsetio Donosepoetro ◽

Andi Wijaya

Keyword(s):

Energy Balance ◽

Waist Circumference ◽

Negative Correlation ◽

Central Obesity ◽

Dynamic Equilibrium ◽

Pearson Correlation ◽

Smoking Habit ◽

Atherogenic Dyslipidemia ◽

Cross Sectional ◽

Significance Level

BACKGROUND: Central obesity is known as the cause of many metabolic disorders called Metabolic Syndrome. Accumulation of adipocytes in central obesity increases production of cytokines proinflammation. Free fatty acid increases in obesity that drives atherogenic dyslipidemia and insulin resistance. IDF 2005 states that waist circumference (WC) is regarded as the simple criteria of obesity. Energy imbalance lasting for a long period is a determinant factor for obesity, e.g. when energy intake is greater than energy expenditure. The brain and gastrointestinal tract work together to maintain this system. Ghrelin and Obestatin are two gut hormones that work in different ways to keep the energy balance. Ghrelin increases appetite but Obestatin decreases it. The two hormones play an important role in maintaining the dynamic equilibrium of energy balance. This study was aimed to determine correlation of Ghrelin and Obestatin with WC in central obese men.METHODS: This was a cross sectional study involving 53 central obese men. Based on IDF 2005 central obesity is most easily measured by waist circumference using the guidelines ethnic group (not country of residence) specific. We used South Asia ethnic which including Chinese, Malay and Asian Indian population as criteria for this study, that was WC >90 cm, aged 20-60 years. Subjects who had smoking habit, any infectious disease, and ACS were excluded from the study. No restriction was applied on the kind of meals the subjects were having or activities they were doing. The correlation of waist circumference with ghrelin and obestatin was assessed with a significance level of 95% (α=0,05).RESULTS: Patient's age was 40.9623±7.9080 year, waist circumferences was 102.1981±10.2696 cm, weight was 85.8679±16.5475 kg, height was 168.8066±6.3535 cm, BMI was 29.9723±2.4937 kg/m2. Concentration of Ghrelin were 0.70-13.72 ng/mL, and Obestatin 16.66-148.84 pg/mL. Pearson correlation showed that Ghrelin (r=-0.1114, p=0.4271) and Obestatin (r=-0.1781, p=0.2020) had no significant correlation with WC. But in patients WC ≥120 cm had significant negative correlation with Obestatin (r=-0.375, p=0.049).CONCLUSIONS: There was no significant correlation of Ghrelin and Obestatin with WC in obese men. However, there was a negative correlation tendency found in patients with greater WC (≥102 cm).KEYWORDS: obesity, ghrelin, obestatin, waist circumference (WC)

Download Full-text

Association of Metabolic Syndrome Parameters with Kidney Stones in Indonesia

Unnes Journal of Public Health ◽

10.15294/ujph.v8i2.28690 ◽

2019 ◽

Vol 8 (2) ◽

pp. 88-98

Author(s):

La’elatul Fazriyah ◽

Mahalul Azam ◽

Indah Septiani ◽

Yuni Wijayanti

Keyword(s):

Metabolic Syndrome ◽

Kidney Stones ◽

Kidney Stone ◽

Central Obesity ◽

Secondary Data ◽

Cross Sectional Study ◽

Stone Disease ◽

Dominant Factor ◽

Chi Square ◽

Cross Sectional

Kidney stone disease is common throughout the world. Elevated prevalence of kidney stones is often associated with metabolic syndrome itself. This study aimed to assess the association between kidney stones and metabolic syndrome parameters in differences gender. This was a cross-sectional study with Chi-square and multivariate logistic regression for data analysis from the secondary data Riskesdas 2013 with 26,063 respondents. Diagnosis of kidney stone based on Riskesdas 2013 interview, metabolic syndrome based on NCEP ATP-III and PERKENI. Result showed that there were 226 (0.9%) diagnosed kidney stones cases by doctors. After adjustment age, central obesity was dominant factor which associated with the risk of kidney stones in male (OR 1.9; 95% CI 1.3-2.9; p=0.003) and metabolic syndrome was dominant factor which associated with the risk of kidney stones in female (OR 6.1; 95% CI 3.4-11.3; p<0.001). The conclusion was that metabolic syndrome and central obesity were associated with risk of kidney stones.

Download Full-text

What are the optimal cut-off points of anthropometric indices for prediction of overweight and obesity? Predictive validity of waist circumference, waist-to-hip and waist-to-height ratios

Health Promotion Perspectives ◽

10.34172/hpp.2020.23 ◽

2020 ◽

Vol 10 (2) ◽

pp. 142-147 ◽

Cited By ~ 1

Author(s):

Helda Tutunchi ◽

Mehrangiz Ebrahimi-Mameghani ◽

Alireza Ostadrahimi ◽

Mohammad Asghari-Jafarabadi

Keyword(s):

Waist Circumference ◽

Roc Curve ◽

Predictive Ability ◽

Diagnostic Value ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Roc Curve Analysis ◽

Anthropometric Indices ◽

Cross Sectional ◽

Anthropometric Indicators

Background: Planning for obesity prevention is an important global health priority. Our aim in this study was to find the optimal cut-off points of waist circumference (WC), waist- to- hipratio (WHR) and waist- to- height ratio (WHtR), as three anthropometric indices, for prediction of overweight and obesity. We also aimed to compare the predictive ability of these indices to introduce the best choice. Methods: In this cross-sectional study, a total of 500 subjects were investigated. Anthropometric indicators were measured using a standard protocol. We considered body mass index (BMI) as the simple and most commonly used index for measuring general obesity as the comparison indicator in the present study to assess the diagnostic value for other reported obesity indices.We also performed receiver operating characteristic (ROC) curve analysis to define the optimal cut-off points of the anthropometric indicators and the best indices for overweight and obesity. Results: The proposed optimal cut-offs for WC, WHtR, and WHR were 84 cm, 0.48 and 0.78for women and 98 cm, 0.56 and 0.87 for men, respectively. The area under the ROC curve ofWHtR (women: AUC=0.97, 95% CI: 0.96-0.99 vs. men: AUC=0.97, 95%CI: 0.96-0.99) and WC(women: AUC=0.97, 95% CI, 0.95-0.99 vs. men: AUC=0.98, 95% CI: 0.97-0.99) were greater than WHR (women: AUC=0.79, 95% CI =0.74-0.85 vs. men: AUC=0.84, 95% CI=0.79-0.88). Conclusion: This study demonstrated that the WC and WHtR indicators are stronger indicators compared to the others. However, further studies using desirable and also local cutoffs against more accurate techniques for body fat measurement such as computerized tumor (CT) scans and dual-energy x-ray absorptiometry (DEXA) are required.

Download Full-text

Hyperhomocysteinemia Concurrent with Metabolic Syndrome Is Independently Associated with Chronic Kidney Disease among Community-Dwelling Adults in an Urban Korean Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186810 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6810

Author(s):

Hana Moon ◽

Hae-Jin Ko ◽

A-Sol Kim

Keyword(s):

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Odds Ratio ◽

Central Obesity ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

The Difference

Elevated homocysteine (Hcy) levels and metabolic syndrome (MetS) are associated with chronic kidney disease (CKD). We investigated the combined effects of hyperhomocysteinemia (HHcy) and MetS on CKD among community-dwelling adults in an urban area of South Korea. We also identified the combination of HHcy and individual MetS components associated with the maximal risk of CKD. A retrospective cross-sectional study involving 19,311 health examinees between 2 January 2011 and 31 December 2015 was conducted. The participants were divided into four groups—namely, the HHcy−/MetS−, HHcy−/MetS+, HHcy+/MetS−, and HHcy+/MetS+ groups. CKD was defined as a low eGFR <60 mL/min/1.73 m2 or albuminuria. The HHcy+/MetS+ group had a higher risk of CKD than the HHcy−/MetS+ group (odds ratio (OR): 1.750, p = 0.002 for males; OR: 3.224, p < 0.001 for females). The HHcy+/MetS+ group had a higher CKD risk than the HHcy+/MetS− group; however, the difference was not statistically significant (OR: 1.070, p = 0.712 for males; OR: 1.847, and p < 0.074 for females). HHcy concurrent with MetS increased the CKD risk. Among the combinations of HHcy and MetS components, the coexistence of HHcy and central obesity had the greatest effect on CKD. Therefore, the timely detection and treatment of HHcy and MetS are important for preventing CKD.

Download Full-text