Korean J Fam Med.  2013 Sep;34(5):307-318. 10.4082/kjfm.2013.34.5.307.

The Cutoff Value of Waist Circumference for Predicting Metabolic Risks in Pre- and Post-Menopausal Korean Women: Analysis of 2010 Korean National Health and Nutrition Examination Survey Data

• Lee OG
• Hur YI
• Kang JH
• Park HA
• Kim KW
• Cho YG
• Choi WY
• Park H
• Lee HA

• KMID: 2234951
• DOI: http://doi.org/10.4082/kjfm.2013.34.5.307

Abstract

BACKGROUND
With metabolic syndrome (MS) being a major risk factor for cardiovascular disease, and central obesity being a major predisposing factor for MS, intensive research is currently being performed on cutoff values according to race and sex. Menopause is an especially significant factor in designating cutoff values for female central obesity, as menopause brings sudden bodily changes that induce central obesity and increased prevalence of MS. Therefore this study aimed to investigate the cutoff values for the obesity index and its validity in predicting the criteria for MS in Korean women according to menstrual status.
METHODS
The study focused on 3,103 women 20 years of age or older participating in the 2007 Korea National Health and Nutrition Examination Survey. Definitions of non-adipose components of MS were defined by the International Diabetes Federation, and menstrual status was judged on the basis of survey results. The sensitivity, specificity, and positive and negative predictive values of the central obesity index (body mass index [BMI], waist circumference [WC], waist-to-height ratio [WHtR]) according to menstrual status for two or more non-adipose components of MS were calculated based on the Youden index.
RESULTS
Area under the curve (AUC) values predicting the presence of two or more metabolic risk factors were higher in pre-menopausal women, with AUC values for BMI, WC, and WHtR being, in pre- and post-menopausal women, 23.1 kg/m2 vs. 23.9 kg/m2, 76.1 cm vs. 82.5 cm, and 0.49 vs. 0.53, respectively. The WC cut off (76 cm) for pre-menopausal women was found to be more sensitive and more effective at screening for MS risks than the cutoff value given by the Korea Society for the Study of Obesity.
CONCLUSION
The central obesity index showed better predictability for MS risk in pre-menopausal women. Because the central obesity index cutoff values are lower in pre-menopausal women, the possibility of metabolic risk can be considered for pre-menopausal women with WC lower than 85 cm. Assessment and control of other risks are needed accordingly for preventing the development of MS.

Keyword

Women; Menopause; Abdominal Obesity; Waist Circumference; Body Mass Index; Waist-to-height Ratio; Cutoff Value; Metabolic Syndrome

MeSH Terms

Area Under Curve
Body Mass Index
Cardiovascular Diseases
Continental Population Groups
Female
Humans
Korea
Mass Screening
Menopause
Nutrition Surveys
Obesity
Obesity, Abdominal
Prevalence
Risk Factors
Sensitivity and Specificity
Waist Circumference