Anthropometric indices: How they compare in screening of cardio-metabolic risks in a Nigerian sub-population.
Abstract
Background: The current anthropometric indices used for diagnosis of cardio-metabolic syndrome (CMS) in sub-Saharan Africa are those widely validated in the western world. We hereby aim to compare the sensitivity and specificity of these tools in identifying risk factors for CMS.
Method: The study assessed body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Statistical analyses were performed to determine the sensitivity and specificity of WHtR in comparison with WC cut-off points recommended by the International Diabetes Federation (IDF) and the Third Adult Treatment Panel (ATPIII) as well as BMI cutoffs prescribed by the World Health Organisation (WHO).
Result: WHtR had the highest area under the receiver operating characteristic (ROC) curve in screening CMS. WHtR >0.5 also showed highest sensitivity in both genders in identifying CMS and clusters of >2 CMS risk factors, but with lowest specificity and positive likelihood ratio (LR+). ATPIII WC cut-off revealed lowest sensitivity and highest specificity in screening CMS and >2 CMS risk factors in males (p<0.0001). IDF WC threshold had the more stable sensitivity and specificity in males (p<0.0001) but not in females.
Conclusion: WHtR>0.5 is more sensitive than WC and BMI recommended values in screening for CMS, but with the least positive likelihood ratio. However, more studies in other nations of sub-Saharan Africa are needed to assure evaluation of different cut points that will yield optimal specificity and sensitivity. This will help curb the problem of over-diagnosis of CMS risk factors and increase better health outcome of the population.
Keywords: Anthropometric indices, cardio-metabolic syndrome, Nigeria
Résumé
Contexte: Les indices anthropométriques actuels utilisés pour le diagnostic du syndrome cardio-métabolique (SCM) en Afrique sub-saharienne sont celles qui sont largement validé dans le monde occidental. Nous voulons par ainsi comparer la sensibilité et la spécificité de ces outils pour identifier les facteurs risque pour leSCM.
Méthode: L’étude a évalué l’indice de masse corporelle (IMC), lacirconférence de la taille (CT) et le rapport taille-hauteur (RTH). Les analyses statistiques ont été réalisées pour déterminer la sensibilité et la spécificité duRTH en comparaison avec lesseuilsde laCT recommandé par la Fédération Internationale du Diabète (FID) et le TroisièmePanel de Traitementd’Adulte (PTAIII), ainsi que lesseuils de l’IMC prescrits par L’Organisation Mondiale de la Santé (OMS).
Résultat: RTH avait la plus forte aire sous la courbe caractéristique opérantdu receveur (COR) dans le dépistage duSCM. RTHe”0.5 a également montré une sensibilité plus élevée dans les deux sexes dans l’identification des SCM et des clusters e”2 desfacteurs risquedeSCM, mais avec la plus faible spécificité et rapport de probabilité positif (LR +). Le seuilde la CTPTAIII a révélé la plus faible sensibilité etla plus élevéespécificité dans le dépistage duSCM et e”2 facteurs risquedeSCM chez les hommes (p <0,0001). Le seuil de laCTFID avait laplus stable sensibilité et spécificité chez les hommes (p <0,0001), mais pas chez les femmes.
Conclusion: RTH> 0,5 est plus sensible que les valeurs de la CT et de l’IMC recommandé dans le dépistage duSCM, mais avec lemoins positif rapport de probabilité. Cependant, plus d’études dans d’autres pays d’Afrique sub-saharienne sont nécessaires pour assurer l’évaluation des différents seuils qui donneront spécificité et sensibilitéoptimale. Cela aidera à modérer le problème de sur-diagnostic des facteurs risque duSCM et d’augmenter meilleurs résultats pour la santé de la population.
Mots-clés: Indices anthropométriques, syndrome cardio-métabolique, Nigeria
Correspondence: Mr. Victor M Oguoma, School of Psychological and Clinical Sciences, Charles Darwin University, Darwin , Northern Territory, 0909, Australia. E-mail: victormaduabuchi.oguoma@edu.edu.au; oguomavm@yahoo.com
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