Abstract:
Back ground: Metabolic syndrome (MetS) is a complex disorder which is characterized by
clustering of interrelated risk factors of cardiovascular disease and diabetic mellitus. So far,
cutoff point variability for one of the cluster to define MetS, which is waist circumference, based
on ethnicity was documented.
Objective: To determine waist circumference cutoff point to define MetS among type II diabetic
patients.
Methods: Institution based cross sectional study was conducted from March to April 2017 at
Ayder Comprehensive Specialized Hospital among type II diabetic mellitus (T2DM) patients.
Systematic sampling technique was used to select study participants and 520 of them were
assumed to be included in the study. Data were collected by checklist, anthropometric
measurements and biochemical analyses. Fasting blood sample was collected for the biochemical
evaluation. Data were entered to Epi-info 3.5.1 and transferred to SPSS 20 for analysis.
Participants having more than one abnormal MetS components were categorized as cases. The
classification power of waist circumference (WC) to distinguish cases from controls was
determined by ROC curve analysis. WC cutoff point was determined by taking the point which
was having maximum Youden Index.
Results: A total of 520 participants were included in the study, of whom 308(59.2%) were
females. The mean age of the participants was 56 ± 10.8 years and 55 ± 11.4 years for males and
females respectively. The classification power of WC was 0.67 (0.58-0.75) for male and 0.63
(0.52-0.73) for females. The optimal waist circumference cutoff point to predict the presence of
at least two other components of the MetS was 95.5 cm (sensitivity 39.8%, specificity86.3%, p
value < 0.001) for males and 87.5 cm (sensitivity73.1%, specificity54.5%, p value < 0.017) for
females.
Conclusion: The power of WC value to classify cases from controls was poor and the cutoff
points of WC were 87.5 cm and 95.5 cm for female and male respectively. WC cutoff points
need to be reconsidered for these patients using a prospective cohort study. In addition, studies
which can consider the confounders such as lipid lowering medications, age of the participants
and duration of diabetes are advisable in order to increase the classification power of WC.
