Identification of metabolic syndrome using phenotypes consisting of triglyceride levels with anthropometric indices in Korean adults

Abstract

Background: The metabolic syndrome (MetS) has shown strong associations with the hypertriglyceridemic waist (HW) phenotype. The best anthropometric indicator of MetS remains controversial. Furthermore, no studies have investigated alternative indices that could replace waist circumference in the HW phenotype. The objectives of this study were to find the best indicator of MetS among anthropometric indices and to examine the predictive power of phenotypes consisting of triglyceride levels with anthropometric indices. Methods: A total of 12,025 subjects participated in this retrospective cross-sectional study. All subjects were recruited between November 2016 and August 2007 from hospitals in 28 urban and rural regions in South Korea. The data analyzed in this study were obtained from the Korean Health and Genome Epidemiology Study database and the Korea Institute of Oriental Medicine. Results: The proportion of patients with MetS ranged from 9 to 57% according to age and gender groups. Waist circumference (WC) was best indicator of MetS in men of all age groups. However, in women aged 40-49 years, the waist-to-height ratio (WHtR) was the best indicator of MetS. Rib circumference and chest circumference were the strongest indicators in women aged 50-59 years and 70-79 years, respectively. The combination of WC and triglyceride (TG) was the best indicator of MetS in men and women overall. However, interestingly, the best indicator was TG + WHtR in women aged 40-49 years and TG + forehead-to-waist ratio in women aged 70-79 years. Conclusions: The best indicator of MetS in terms of individual anthropometric indices and the various phenotypes combining a single anthropometric index with TG may differ subtly according to age group in women, but not in men. Our findings provide insight into a simple and inexpensive method that could be used to identify MetS in initial health screening efforts in epidemiology and public health.

<p>Screening for Metabolic Syndrome Using an Integrated Continuous Index Consisting of Waist Circumference and Triglyceride: A Preliminary Cross-sectional Study</p>

“…[16][17][18][19][20][21][22][23][24][25][26]33,34,45 Confirming earlier studies, the present study showed significant associations of HW phenotype with the presence of MetS. 16,22,23,25 In those studies, they only used the specific range of WC and TG values to the diagnosis of HW phenotype. Lee et al reported that it was difficult to find the better phenotype consisting of individual measurements and TG on basis of the specific range of TG and WC, 18 indicating that the qualitative nature of HW phenotype may to some extent attenuate its effectiveness.…”

“…Interestingly, Lee et al have suggested that the best indicators of MetS in terms of individual anthropometric indices and the various phenotypes combining a single anthropometric index with TG may differ subtly according to age group in women other than in men in their latest report. 16 In this study, we also found that the ability of WTI, HW phenotype and TyG to screen for MetS may differ between genders. Unlike those studies, we transformed the qualitative HW phenotype into a specific continuous variable (WTI), and found that the one-SD increment of WTI significantly increased the odds of MetS in both genders.…”

“…To determine HW phenotype, we considered the definition of the HW phenotype reported in recent studies. 16,18,33,34 The HW phenotype was defined as follows: TG ≥1.5 mmol/L and WC ≥85 cm in women and TG ≥2.0 mmol/L and WC ≥90 cm in men. Therefore, men with TG <2.0 mmol/L and/or WC <90 cm and women with TG <1.5 mmol/L and/or WC <85 cm were considered normal participants.…”

“…16 Recently, a large number of studies have suggested using the hypertriglyceridemic waist (HW) phenotype, due to its simple and cost-effective measurement, as an alternative indicator of chronic disease or metabolic disorder, including prediabetes or diabetes, [17][18][19][20][21] CVD, 22,23 and MetS. 16,24,25 However, whether the HW phenotype has a better discriminative power to identify individuals with cardiometabolic risk factors or metabolic diseases is still controversial. Some studies suggested that the concurrent use of WC and triglyceride (TG) levels could be more useful in prevalence studies of T2DM and CVD compared with the use of WC or TG alone.…”

Identification of Hepatic Steatosis in Premenopausal and Postmenopausal Women Based on Phenotypes Combining Triglyceride Levels and Anthropometric Indices: A Cross-Sectional Study

“…Recent reports have defined HWP as follows: TG level ≥ 1.50 mmol/L and WC ≥ 85cm in women. 16 Therefore, women with TG level< 1.50 mmol/L or WC < 85cm were regarded as not having HWP.…”