Barbosa Paulo José Bastos, Lessa Ines, de Almeida Filho Naomar, Magalhães Lucélia Batista N Cunha, Araújo Jenny
Universidade Federal da Bahia, Salvador, BA, Brazil.
Arq Bras Cardiol. 2006 Oct;87(4):407-14. doi: 10.1590/s0066-782x2006001700003.
To identify and propose the optimal waist circumference cut-off points (WCp) for the diagnosis of central obesity (CO) in a Brazilian population, so as to compare these cut-off points with those recommended by the ATPIII (WC-ATPIII), and to estimate the difference in prevalence rates of metabolic syndrome (MS) using the two criteria.
Cross-sectional study conducted in a population subgroup of 1439 adults in the city of Salvador, Brazil. ROC curves of waist circumference (WC) were plotted to identify diabetes mellitus (DM) and obesity. ROC curve sensitivity and specificity values >60% and the closest to each other were used to define WCp. The prevalence of MS was estimated using WCp and WC-ATPIII.
Eight hundred and twenty nine women comprised 57.7% of the sample. The WCp selected were 84 cm for women and 88 cm for men. These cut-off points detected DM with a 68.7% and 70% sensitivity, and a 66.2% and 68.3% specificity, respectively. For obesity, sensitivity and specificity were 79.8% and 77.6% in women and 64.3% and 71.6% in men, respectively. Using WC-ATPIII, 88 cm (for women) and 102 cm (for men), the sensitivity was 53.3% and 26.5%, respectively, to diagnose DM. For obesity, sensitivity was 66.5% (for women) and 28.6% (for men). The prevalence of MS using WCp was 23.7%, 95%CI (21.6-25.9), whereas using WC-ATPIII it was 19.0%, 95%CI (17.1-20.9), 1.2 times higher using WCp.
WC-ATPIII were inappropriate and underestimated the prevalence of MS in the population studied, particularly among men. We suggest that the WC cut-off points > 84 cm for women and > 88 cm for men should be tested in other Brazilian populations.
确定并提出巴西人群中用于诊断中心性肥胖（CO）的最佳腰围切点（WCp），以便将这些切点与ATPIII推荐的切点（WC - ATPIII）进行比较，并使用这两种标准估计代谢综合征（MS）患病率的差异。
对巴西萨尔瓦多市1439名成年人的人群亚组进行横断面研究。绘制腰围（WC）的ROC曲线以识别糖尿病（DM）和肥胖症。使用ROC曲线敏感度和特异度值>60%且彼此最接近的情况来定义WCp。使用WCp和WC - ATPIII估计MS的患病率。
829名女性占样本的57.7%。选定的WCp女性为84厘米，男性为88厘米。这些切点检测DM的敏感度分别为68.7%和70%，特异度分别为66.2%和68.3%。对于肥胖症，女性的敏感度和特异度分别为79.8%和77.6%，男性分别为64.3%和71.6%。使用WC - ATPIII（女性88厘米，男性102厘米）诊断DM的敏感度分别为53.3%和26.5%。对于肥胖症，敏感度分别为66.5%（女性）和28.6%（男性）。使用WCp时MS的患病率为23.7%，95%CI（21.6 - 25.9），而使用WC - ATPIII时为19.0%，95%CI（17.1 - 20.9），使用WCp时高出1.2倍。
WC - ATPIII不合适，低估了所研究人群中MS的患病率，尤其是在男性中。我们建议应在其他巴西人群中测试女性>84厘米、男性>88厘米的WC切点。
