Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa.
SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa.
Int J Environ Res Public Health. 2022 Aug 18;19(16):10250. doi: 10.3390/ijerph191610250.
Waist circumference (WC) is one of the diagnostic criteria for metabolic syndrome (MetS). However, studies have shown that the waist cut-point may be influenced by BMI. The aim of this study was to, therefore, determine whether the presence of obesity influences the WC cut-point used to diagnose MetS in sub-Saharan African women. The second aim was to determine whether calculated cut-points of other waist-related and dual-energy X-ray absorptiometry (DXA)-determined anthropometric measures used for the diagnosis of MetS were also influenced by BMI. Biochemical, simple anthropometric and dual-energy X-ray absorptiometry-derived anthropometric data were collected in 702 black South African women from the Study of Women Entering and in Endocrine Transition (SWEET). A receiver operating characteristic curve analysis was used to determine waist, waist-to-hip (WHR) and waist-to-height ratios, body shape index (ABSI), total body fat, trunk fat, and peripheral (arm + leg) fat cut-points for MetS (without waist) in subjects with BMI above or below the median value. The estimated WC cut-points (107 cm, 93.5 cm) for women with high BMI and low BMI, respectively, and the cut-points for the other anthropometric variables for the diagnosis of MetS were greater in high BMI women compared to low BMI women. The exceptions were WHR and ABSI, for which the cut-points were very similar in both BMI groups, and peripheral fat, where the cut-point was lower in the high BMI group. Logistic regression analysis demonstrated that WC was associated with a higher risk (odds ratio [95% CIs]: 1.07 [1.04, 1.10]; p < 0.0001), whilst hip was associated with a lower risk (0.97 [0.94, 0.99]; p = 0.02) for MetS. These data suggest that with increasing BMI, the higher levels of protective gluteofemoral fat lead to the requirement for higher WC cut-points for MetS diagnosis. The opposing associations of waist and hip with MetS risk make WHR a more appropriate variable for diagnosing MetS among African women as the WHR cut-point is less influenced by increasing BMI than is WC, which was also observed for ABSI.
腰围（WC）是代谢综合征（MetS）的诊断标准之一。然而，研究表明腰围切点可能受到 BMI 的影响。因此，本研究旨在确定肥胖是否会影响用于诊断撒哈拉以南非洲女性 MetS 的 WC 切点。第二个目的是确定用于诊断 MetS 的其他与腰围相关的和双能 X 射线吸收法（DXA）确定的人体测量学指标的计算切点是否也受到 BMI 的影响。在来自南非女性进入和内分泌过渡期研究（SWEET）的 702 名黑人南非女性中收集了生化、简单人体测量学和双能 X 射线吸收法衍生的人体测量学数据。使用受试者工作特征曲线分析来确定腰围、腰臀比（WHR）和腰围与身高比、身体形状指数（ABSI）、全身脂肪、躯干脂肪和外周（臂+腿）脂肪切点用于无腰围的 MetS（在 BMI 值高于或低于中位数的受试者中）。对于高 BMI 和低 BMI 的女性，分别估计的 WC 切点（107 cm、93.5 cm）和用于诊断 MetS 的其他人体测量学变量的切点在高 BMI 女性中大于低 BMI 女性。例外是 WHR 和 ABSI，这两个切点在两个 BMI 组中非常相似，而外周脂肪的切点在高 BMI 组中较低。逻辑回归分析表明，WC 与更高的风险相关（比值比[95%CI]：1.07[1.04，1.10]；p <0.0001），而臀部与 MetS 风险相关（0.97[0.94，0.99]；p = 0.02）。这些数据表明，随着 BMI 的增加，较高水平的保护性臀股脂肪导致需要更高的 WC 切点来诊断 MetS。腰围和臀部与 MetS 风险的相反关联使得 WHR 成为诊断非洲女性 MetS 的更合适变量，因为 WHR 切点受 BMI 增加的影响小于 WC，这也适用于 ABSI。
