Anthropometric cutoff values for predicting metabolic syndrome in a Saudi community: from the SAUDI-DM study
Zaidia, Khalid Al-Rubean,a Amira M. Youssef, Yousuf Al Farsi,a Ahmad H. Al-Sharqawi,c Nahla Bawazeer,d Mohammad T. Al Otaibi,a Fahd Issa AlRumaih,a Muhammad Shoaib . 2017
BACKGROUND: The prevalence of metabolic syndrome varies widely by ethnicity and by the criteria used
in its definition.
OBJECTIVE: To identify the optimal cutoff values for waist circumference (WC), waist-to-hip ratio (WHR) and
body mass index (BMI) for identifying metabolic syndrome among the Saudi population.
DESIGN: Nationwide household cross-sectional population-based survey.
SETTING: Thirteen health sectors in Saudi Arabia.
SUBJECTS AND METHODS: We used data for subjects in the Saudi Abnormal Glucose Metabolism and
Diabetes Impact Study (SAUDI-DM), which was conducted from 2007 to 2009. Using International Diabetes
Federation (IDF) criteria, metabolic syndrome and its different components were assessed using anthropometric
measurements, blood pressure, fasting plasma glucose, triglycerides and HDL cholesterol. Receiver
operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cutoff
values of WC, WHR, and BMI. The Youden index was used to calculate the optimal cutoff value for each
anthropometric measurement.
MAIN OUTCOME MEASURE(S): Optimal cutoff value for WC, WHR, and BMI for identifying the risk of
metabolic syndrome.
RESULTS: The prevalence of two or more risk factors for metabolic syndrome was observed in 43.42% of
the total cohort of 12 126 study participants ≥18 years of age. The presence of two or more risk factors were
significantly higher among men (46.81%) than women (40.53%) (P<.001). The optimal cutoff values for WC,
WHR, and BMI were 92 cm, 0.89, and 25 kg/m2 for men and 87 cm, 0.81 and 28 kg/m2 for women for identifying
the risk of metabolic syndrome. The prevalence of elevated triglycerides, blood pressure, and fasting
plasma glucose significantly increased with age for both genders.
CONCLUSIONS: The proposed WC cutoff values were better than WHR and BMI in predicting metabolic
syndrome and could be used for screening people at high risk for metabolic syndrome in the Saudi population.
LIMITATIONS: No direct measure of body fatness and fat distribution, cross-sectional design.
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