title: The prevalence of metabolic syndrome and determination of the optimal waist circumference cutoff points in a rural South african community.
abstract: OBJECTIVE
  To determine the prevalence of metabolic syndrome and to define optimal ethnic-specific waist-circumference cutoff points in a rural South African black community.
  
  
  METHODS
  This was a cross-sectional survey conducted by random-cluster sampling of adults aged >15 years. Participants had demographic, anthropometric, and biochemical measurements taken, including a 75-g oral glucose tolerance test. Metabolic syndrome was defined using the 2009 Joint Interim Statement (JIS) definition.
  
  
  RESULTS
  Of 947 subjects (758 women) studied, the age-adjusted prevalence of metabolic syndrome was 22.1%, with a higher prevalence in women (25.0%) than in men (10.5%). Peak prevalence was in the oldest age-group (≥65 years) in women (44.2%) and in the 45- to 54-year age-group in men (25.0%). The optimal waist circumference cutoff point to predict the presence of at least two other components of the metabolic syndrome was 86 cm for men and 92 cm for women. The crude prevalence of metabolic syndrome was higher with the JIS definition (26.5%) than with the International Diabetes Federation (IDF) (23.3%) or the modified Third Report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) (18.5%) criteria; there was very good agreement with the IDF definition (κ = 0.90 [95% CI 0.87-0.94]) and good concordance with ATPIII criteria (0.77 [0.72-0.82]).
  
  
  CONCLUSIONS
  There is a high prevalence of metabolic syndrome, especially in women, suggesting that this community, unlike other rural communities in Africa, already has entered the epidemic of metabolic syndrome. Waist circumference cutoff points differ from those currently recommended for Africans.
authors.affiliation: Department of Diabetes and Endocrinology, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. motala@ukzn.ac.za
authors.forename: Ayesha A
authors.initials: AA
authors.lastname: Motala
authors.forename: Tonya
authors.initials: T
authors.lastname: Esterhuizen
authors.forename: Fraser J
authors.initials: FJ
authors.lastname: Pirie
authors.forename: Mahomed A K
authors.initials: MA
authors.lastname: Omar
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000368:Aged; D044383:Black People; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D012737:Sex Factors; D055105:Waist Circumference / Q000502:physiology*