Optimal cut-off points for waist circumference in the definition of metabolic syndrome: a cross-sectional study in rural Bangladesh.

Abstract

To determine optimal waist circumference (WC) cut-off points for identifying metabolic syndrome (MetS) in Bangladeshi adults, with the aim of enhancing diagnostic accuracy specific to this population. Cross-sectional analysis. Rural community in Chandra, Bangladesh. A total of 2293 adults aged 20 years and older. MetS was defined using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Receiver operating characteristic (ROC) curves and Youden's Index were used to identify WC cut-off points that maximised sensitivity and specificity for diagnosing MetS. Restricted cubic spline regression was employed to explore the non-linear relationship between WC and MetS risk. The optimal WC cut-off points for predicting MetS were 90 cm for men (sensitivity 55.2%, specificity 94.3%, OR 12.5, 95% CI 8.6 to 18.0) and 80 cm for women (sensitivity 86.7%, specificity 71.9%, OR 15.6, 95% CI 11.4 to 21.3). The area under the ROC curve was 0.819 for men and 0.827 for women. Non-linear analysis indicated a significant increase in MetS risk beyond these thresholds, with a steeper risk gradient observed in men. This study establishes WC cut-off points of 90 cm for men and 80 cm for women as optimal for diagnosing MetS in Bangladeshi adults, underscoring the necessity of population-specific diagnostic criteria to improve early detection and management.