Examining waist and neck circumferences as screening tools for metabolic syndrome in a sub-Saharan Caucasian cohort at three year follow-up: the SABPA prospective cohort

Abstract

Objectives: Waist circumference (WC) cut-off points specific to sub-Saharan Caucasians do not exist with which to identify metabolic syndrome. Neck circumference (NC), as an additional measure, was previously found to be a worthy identifier of metabolic syndrome. Therefore, the aim was to determine NC and WC cut-off points specific to our Caucasian cohort, to confirm baseline cut-off points and to determine whether or not WC cut-off points specific to this cohort differed from the Joint Interim Statement (JIS) WC guidelines. Design, subjects and setting: A target population study, nested in a prospective cohort, was assessed and included 90 and 96 Caucasian men and women aged 24-65 years from the Dr Kenneth Kaunda Municipality District, North West province. Outcomes measures: Anthropometric and fasting biological markers for metabolic syndrome, e.g. systolic and diastolic blood pressure, glucose, triglycerides and high-density lipoprotein, were obtained. Results: Cut-off points were determined with the use of a receiver operating characteristic. With the use of cohort specific WC cut-offs, metabolic syndrome prevalence did not change. WC cut-off points were 96 cm for men and 88 cm for women. NC cut-off points were 42 cm and 35 cm, for men and women, respectively. Conclusion: WC cut-off points specific to these Caucasians differed to those from the JIS guidelines, but corresponded with the baseline findings of the prospective cohort. From a clinical perspective, we cautiously suggest the application of NC, rather than WC, as an anthropometric measure of metabolic syndrome in women as it was a stronger predictor of metabolic syndrome and is not influenced by menopausal status per se.