Screening for the metabolic syndrome in a public care hospital clinic population: A simple measurement of waist circumference

Background: Metabolic syndrome is a collection of anthropomorphic and metabolic derangements that, taken together, constitute a strong predictor of stroke, cardiovascular disease, type 2 diabetes, and perhaps other disorders. Diagnosing the metabolic syndrome according to presently accepted definitions requires a mixture of anthropomorphic and laboratory measurements. In indigent patient populations or locations that lack adequate laboratory facilities, a noninvasive low-cost or costfree alternative would be beneficial as a preliminary screening measure. Methods: To identify potential means for the diagnosis, we evaluated anthropomorphic measures individually and in combination for their predictive value against the standard classification. Receiver operator characteristic curves identified optimal cutoff values for the variables tested, and consideration of sensitivity and specificity were considered concerning the consequences of false negatives and positives. Results: Receiver operator characteristic curves showed that only waist circumference in men gave acceptable specificity and sensitivity. Combinations of measurements did not improve on a simple measurement of waist circumference. Conclusions: Waist circumference was a potentially useful single indicator in men but not in women. Other values and combinations were evaluated as well. Waist measurement alone may serve as sufficient screening in men in locations where laboratory facilities are lacking or funds are severely limited, as in developing countries.