Waist circumference cut-off points for the diagnosis of metabolic syndrome in Iranian adults

Aims: Central obesity, a prominent feature of metabolic syndrome (MetS), is commonly assessed by gender- and ethnicity-specific waist circumference (WC) cut-off values. Since 2006, the recommended WC cut-offs by the International Diabetes Federation (IDF) for Europeans are used in Iran because of limited data availability. The purpose of this study was to determine optimal cut-off points for the diagnosis of MetS in Iran. Methods: A total of 2752 adults (1046 men) were studied. Subjects with two or more of the following risk factors from the IDF criteria were considered to have multiple risk factors: hyperglycemia (FBG ≥ 100 mg/dL or diagnosed diabetes), high blood pressure (SBP ≥ 130 mmHg, DBP ≥ 85 mmHg, or using antihypertensive drugs), low HDL (<50 mg/dL for females and <40 mg/dL for males), and high TG (>150 mg/dL). Results: The WC cut-off yielding maximum sensitivity plus specificity for predicting the presence of multiple risk factors was 91.5 cm in men and 85.5 cm in women. Sensitivity and specificity were 77% (86%) and 58% (50%) in men (women), respectively. MetS prevalence was estimated to be approximately 27% in Tehran. Conclusions: WC cut-offs recommended by the IDF are not appropriate for use in Iran.