The Optimal Ethnic-Specific Waist-Circumference Cut-Off Points of Metabolic Syndrome among Low-Income Rural Uyghur Adults in Far Western China and Implications in Preventive Public Health

Abstract

Background: Metabolic syndrome is pandemic; however, the cut-off values for waist circumference (WC) vary widely depending on the ethnic groups studied and the criteria applied for WC measurement. Previous studies for defining optimal WC cut-off points included high-income and urban settings, and did not cover low-income, rural settings, especially for ethnic minorities. This study aimed at defining optimal ethnic-specific WC cut-off points in a low-income, rural population comprising the largest inhabitant minority group residing in far Western China. Methods: Questionnaire-based surveys, physical examinations, and blood testing of 3542 individuals were conducted in 2010, using a stratified cluster random sampling method in rural Uyghur residents (≥18 years old) from 12 villages in Xinjiang, China, approximately 4407 km away from the capital city, Beijing. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Optimal, ethnic-specific WC cut-off values for diagnosing metabolic syndrome were determined using receiver operator characteristic (ROC) curve analysis. Results: As WC increased, there was a significant, increasing trend of detection and risk in rural Uyghur adults, regardless of the presence of ≥1 or ≥2 components of metabolic syndrome by IDF criteria. The optimal ethnic-specific WC cut-off point to predict the presence of metabolic syndrome was 85 cm for men and 82 cm for women. With these cut-off points, the prevalence rates of metabolic syndrome among men, women, and overall population in Uyghur adults were 19.5%, 23.0%, and 21.3%, respectively. Conclusions: We report a high prevalence of metabolic syndrome, especially in women, among rural Uyghurs in Western China. A WC cut-off of 85 cm in men and 82 cm in women was the best predictor of metabolic syndrome in this population. Because of the cost-effectiveness in measuring WC, we recommend that these WC cut-off points be integrated into local preventive policies for public health as the primary screening criteria for metabolic syndrome and related diseases among low-income, rural minorities.

Prevalence of metabolic syndrome among ethnic groups in China

“…However, China is a multi-ethnic country with at least 55 ethnic groups. There are few studies focused on MetS among different ethnic groups in China, and most of these studies focused on a single ethnic group [7,12,13]. The heterogeneity in study design, inclusion criteria and definition of MetS makes it difficult to compare the prevalence in different ethnic groups.…”

Optimal waist circumference cut-off points for predicting metabolic syndrome among low-income black South African adults

“…Controversies exist concerning the correct anthropometric values relative to ethnicity, genetic background, sex, and sociocultural context [ 11 ]. Studies have shown that WC is among the most powerful tools for predicting METs and that the optimal cut-off values for various indices, including WC, may differ by sex and race [ 12 – 16 ].…”

Comparison of Anthropometric Measures in US Military Personnel in the Classification of Overweight and Obesity

“…As previously mentioned, our sample sizes were not adequate to explore results stratified by age. Similarly, we could not stratify by race/ethnicity, although race/ethnicity may affect the accuracy of body composition cutoffs and the association between visceral fat and health risks . Third, our sample was only 22.1% female.…”