The Pooled Cut-off Point of Waist Circumference as Core Component of Metabolic Syndrome Diagnosis among the Iranian Population; a Systematic Review and Meta-Analysis
Men's Health Journal,
Vol. 5 No. 1 (2021),
6 Dey 2021
,
Page e8
https://doi.org/10.22037/mhj.v5i1.34149
Abstract
Introduction: According to a nationwide study, one-third of the Iranian population suffer from metabolic syndrome (MetS). The most controversial criteria for the diagnosis of MetS is central obesity which would be defined by waist circumference (WC) and needed to be gender and ethnic-specific. There are several national studies that reported different cut-offs for WC so the present study aimed to do a systematic review and meta-analysis to achieve an overall statistical estimate of WC for the Iranian population. Method: A comprehensive search was conducted in international databases from inception to June 2020. The search keywords were waist circumference AND metabolic syndrome AND cut AND Iran. We used the QUADAS-2 tool for quality assessment and the HSROC model for estimating pooled specificity, sensitivity, and the cut-off point from included studies in R software. Results: A total of 3571 studies were evaluated and 24 studies fulfilled the inclusion criteria. Finally, 8 studies were included. All the studies were cross-sectional. Studies with missing MetS prevalence were excluded. Most of the studies had an unclear risk of bias in patient selection. There was a wide variation among reported cut-offs for WC from national and original studies. The Pooled cut-off points of WC for the diagnosis of MetS was 90.55 cm (95%CI: 90.51-90.60) in men and 89.24 cm (95%CI: 89.13-89.36) in women. The pooled sensitivity and specificity in men were 0.67 and 0.68, respectively and the pooled sensitivity and specificity in women were 0.61 and 0.57, respectively. Conclusion: Our results were highly consistent with the only national study and the only consensus about WC cut-off. Further nationwide studies are suggested to be involved in a Mata-analysis for calculating more precise WC cut-off.
- Central Obesity; Iran; Metabolic syndrome; Waist circumference
How to Cite
References
Mansourian M, Babahajiani M, Jafari-Koshki T, Roohafza H, Sadeghi M, Sarrafzadegan N. Metabolic Syndrome Components and Long-Term Incidence of Cardiovascular Disease in Eastern Mediterranean Region: A 13-Year Population-Based Cohort Study. Metab Syndr Relat Disord. 2019;17(7):362-6.
Grundy SM. Atlas of atherosclerosis and metabolic syndrome: Springer Science & Business Media; 2011.
Turk-Adawi K, Sarrafzadegan N, Fadhil I, Taubert K, Sadeghi M, Wenger NK, et al. Cardiovascular disease in the Eastern Mediterranean region: epidemiology and risk factor burden. Nature Reviews Cardiology. 2018;15(2):106.
Farmanfarma KK, Kaykhaei MA, Adineh HA, Mohammadi M, Dabiri S, Ansari-moghaddam A. Prevalence of metabolic syndrome in Iran: A meta-analysis of 69 studies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(1):792-9.
Talaei M, Thomas GN, Marshall T, Sadeghi M, Iranipour R, Oveisgharan S, et al. Appropriate cut-off values of waist circumference to predict cardiovascular outcomes: 7-year follow-up in an Iranian population. Intern Med. 2012;51(2):139-46.
Alberti K, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation. 2009;120(16):1640-5.
Gharipour M, Sarrafzadegan N, Sadeghi M, Andalib E, Talaie M, Shafie D, et al. Predictors of metabolic syndrome in the Iranian population: waist circumference, body mass index, or waist to hip ratio? Cholesterol. 2013;2013:198384.
Hajian-Tilaki K, Heidari B, Hajian-Tilaki A, Firouzjahi A, Bagherzadeh M. The Discriminatory Performance of Body Mass Index, Waist Circumference, Waist-To-Hip Ratio and Waist-To-Height Ratio for Detection of Metabolic Syndrome and Their Optimal Cutoffs among Iranian Adults. Journal of Research in Health Sciences. 2014;14(4):276-81.
Azizi F KD, Aghajani H, Esteghamati A, Hosseinpanah F, Delavari D, Hadaegh F. Appropriate waist circumference cut-off points among Iranian adults: the first report of the Iranian National Committee of Obesity. Arch Iran Med. 2010;13(3):243.
Ramesh T, Igoumenou A, Montes MV, Fazel S. Use of risk assessment instruments to predict violence in forensic psychiatric hospitals: a systematic review and meta-analysis. European psychiatry. 2018;52:47-53.
Sánchez-García AB, Galindo-Villardón P, Nieto-Librero AB, Martín-Rodero H, Robins DL. Toddler screening for autism spectrum disorder: A meta-analysis of diagnostic accuracy. Journal of autism and developmental disorders. 2019;49(5):1837-52.
Wang F, Zhang J, Yu J, Liu S, Zhang R, Ma X, et al. Diagnostic accuracy of monofilament tests for detecting diabetic peripheral neuropathy: a systematic review and meta-analysis. Journal of diabetes research. 2017;2017.
Arellano-Ruiz P, Garcia-Hermoso A, Cavero-Redondo I, Pozuelo-Carrascosa D, Martinez-Vizcaino V, Solera-Martinez M. Homeostasis Model Assessment cut-off points related to metabolic syndrome in children and adolescents: a systematic review and meta-analysis. Eur J Pediatr. 2019;178(12):1813-22.
Neyeloff JL, Fuchs SC, Moreira LB. Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC research notes. 2012;5(1):1-6.
Sharifi F, Mousavinasab N, Mazloomzadeh S, Jaberi Y, Saeini M, Dinmohammadi M, et al. Cutoff point of waist circumference for the diagnosis of metabolic syndrome in an Iranian population. Obes Res Clin Pract. 2008;2(3):I-II.
Gozashti MH, Najmeasadat F, Mohadeseh S, Najafipour H. Determination of most suitable cut off point of waist circumference for diagnosis of metabolic syndrome in Kerman. Diabetes Metab Syndr. 2014;8(1):8-12.
Esteghamati A, Ashraf H, Rashidi A, Meysamie A. Waist circumference cut-off points for the diagnosis of metabolic syndrome in Iranian adults. Diabetes Res Clin Pract. 2008;82(1):104-7.
Shahbazian H, Latifi SM, Nouhjah S. Cut-Off Point of Waist Circumference Used for the Diagnosis of Metabolic Syndrome Among Adult Population in Ahvaz, Southwestern Iran. Jentashapir Journal of Health Research. 2015;6(4).
Fatemeh K. Evaluation of sensitivity and specificity of waist circumference for predicting the cardiovascular risk factors: Qazvin University Of Medical Sciences; 2014.
Sharifi F, Mirarefin M, Fakhrzadeh H, Zerafati N, Badamchizade Z, Edalat B, et al. Comparison of Waist Circumference and Metabolic Syndrome as a Prognostic Value of Insulin Resistance in Elderly Residents of Kahrizak. Iranian Journal of Ageing. 2009;4(3):0-.
Lear S, James P, Ko G, Kumanyika S. Appropriateness of waist circumference and waist-to-hip ratio cutoffs for different ethnic groups. European journal of clinical nutrition. 2010;64(1):42-61.
Stevens J, Katz EG, Huxley RR. Associations between gender, age and waist circumference. European journal of clinical nutrition. 2010;64(1):6-15.
Sonmez A, Bayram F, Barcin C, Ozsan M, Kaya A, Gedik V. Waist circumference cutoff points to predict obesity, metabolic syndrome, and cardiovascular risk in Turkish adults. International Journal of Endocrinology. 2013;2013.
Gao M, Wei Y, Lyu J, Yu C, Guo Y, Bian Z, et al. The cut-off points of body mass index and waist circumference for predicting metabolic risk factors in Chinese adults. Zhonghua liu Xing Bing xue za zhi= Zhonghua Liuxingbingxue Zazhi. 2019;40(12):1533-40.
Pratyush DD, Tiwari S, Singh S, Singh SK. Waist circumference cutoff and its importance for diagnosis of metabolic syndrome in Asian Indians: A preliminary study. Indian Journal of Endocrinology and Metabolism. 2012;16(1):112.
Owolabi EO, Ter Goon D, Adeniyi OV, Ajayi AI. Optimal waist circumference cut-off points for predicting metabolic syndrome among low-income black South African adults. BMC research notes. 2018;11(1):22.
Delavari A, Forouzanfar MH, Alikhani S, Sharifian A, Kelishadi R. First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East: the national survey of risk factors for noncommunicable diseases of Iran. Diabetes care. 2009;32(6):1092-7.
- Abstract Viewed: 194 times
- pdf Downloaded: 148 times