Lubogo David, Wamani Henry, Mayega Roy William, Orach Christopher Garimoi
Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
PLOS Glob Public Health. 2025 Apr 9;5(4):e0003059. doi: 10.1371/journal.pgph.0003059. eCollection 2025.
Metabolic syndrome (MetS) poses a significant challenge to global public health, due to its strong association with Type 2 diabetes and cardiovascular disease. Waist circumference (WC) is a convenient metric for diagnosing MetS. Our study sought to establish waist circumference cut-off points that predict MetS among females of reproductive age in Wakiso district, central Uganda.The data collected were from a cross-sectional study conducted in Wakiso district, central Uganda, involving 697 randomly selected females aged 15 to 49, between 9th June 2021 and 17th August 2021. Data included MetS components: WC, High-Density Lipoprotein (HDL) Cholesterol, triglycerides, blood pressure, and fasting blood glucose. MetS status was identified based on two or more MetS components excluding WC. ROC analysis established the average optimal WC. The accuracy and performance of the cut-off points were evaluated through sensitivity, specificity, positive likelihood ratio, and the Youden Index. Of the 634 participants who were aged 18-49 years, 51.4% had two or more MetS risk factors. Their average optimal WC threshold was 80.3 cm. Variations in optimal WC thresholds were observed across different age groups: 80.4 cm (18-24 years), 79.9 cm (25-34 years), 85.6 cm (35-44 years), and 91.1 cm (45-49 years) respectively. The area under the ROC curve at the cut point for these age groups ranged from 0.78 to 0.86, indicating good discriminatory capability. The sensitivity ranged from 85% to 97%, specificity from 58% to 88%, and the Youden Index from 0.557 to 0.729. A waist circumference of 80.3 cm was the optimal threshold for identifying metabolic syndrome in females between the ages of 18 and 49 years in the setting. This finding concurs with the guidance set forth by the International Diabetes Federation. Additionally, study participants' WC cut-offs varied, ranging from 79.9 cm to 91.1 cm, depending on their age.
代谢综合征（MetS）对全球公共卫生构成了重大挑战，因为它与2型糖尿病和心血管疾病密切相关。腰围（WC）是诊断代谢综合征的一个便捷指标。我们的研究旨在确定乌干达中部瓦基索区育龄女性中预测代谢综合征的腰围切点。收集的数据来自于在乌干达中部瓦基索区进行的一项横断面研究，该研究在2021年6月9日至2021年8月17日期间随机选取了697名年龄在15至49岁之间的女性。数据包括代谢综合征的组成部分：腰围、高密度脂蛋白（HDL）胆固醇、甘油三酯、血压和空腹血糖。代谢综合征状态是根据除腰围外的两个或更多代谢综合征组成部分来确定的。ROC分析确定了平均最佳腰围。通过敏感性、特异性、阳性似然比和尤登指数评估切点的准确性和性能。在634名年龄在18 - 49岁的参与者中，51.4%有两个或更多代谢综合征风险因素。她们的平均最佳腰围阈值为80.3厘米。在不同年龄组中观察到最佳腰围阈值存在差异：分别为80.4厘米（18 - 24岁）、79.9厘米（25 - 34岁）、85.6厘米（35 - 44岁）和91.1厘米（45 - 49岁）。这些年龄组切点处的ROC曲线下面积在0.78至0.86之间，表明具有良好的区分能力。敏感性在85%至97%之间，特异性在58%至88%之间，尤登指数在0.557至0.729之间。腰围80.3厘米是该地区18至49岁女性识别代谢综合征的最佳阈值。这一发现与国际糖尿病联盟提出的指导意见一致。此外，根据年龄不同，研究参与者的腰围切点有所变化，范围从79.9厘米到91.1厘米。
