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Optimal waist:height ratio cut-off point for cardiometabolic risk factors in Turkish adults

  • Ahmet Selçuk Can (a1), Emine Akal Yıldız (a2), Gülhan Samur (a2), Neslişah Rakıcıoğlu (a2), Gülden Pekcan (a2), Sinan Özbayrakçı (a3), K Erhan Palaoğlu (a4), Mithat Gönen (a5) and Thomas P Bersot (a6)
  • DOI: http://dx.doi.org/10.1017/S1368980009991637
  • Published online: 28 September 2009
Abstract
AbstractObjective

To identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.

Design

Cross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).

Setting

Turkey, 2003.

Subjects

Adults (1121 women and 571 men) aged 18 years and over were examined.

Results

Analysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.

Conclusions

We show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.

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*Corresponding author: Email selcukcan@endokrinoloji.com
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