title: Index of central obesity as a parameter to replace waist circumference for the definition of metabolic syndrome in predicting cardiovascular disease.
abstract: OBJECTIVE
  To compare the suitability of metabolic syndrome definitions in predicting cardiovascular disease (CVD) risk.
  
  
  METHODS
  We analyzed data from a population-based prospective cohort of 3598 participants from Jiangsu, China. Waist circumference was replaced with central obesity [index of central obesity (ICO), a ratio of waist circumference and height] in Cholesterol Education Program Adult Treatment Panel III (ICO-replaced ATPIII) and International Diabetes Federation (ICO-replaced IDF), respectively. Cox proportional-hazards regression model and the receiver operating characteristic curve (ROC curve) was used to evaluate the suitability of ATPIII, IDF, ICO-replaced IDF and ICO-replaced ATPIII in predicting CVD risk.
  
  
  RESULTS
  ICO was a better parameter in predicting CVD risk by ROC curve analysis. The ROC curve analysis also showed that although ICO-replaced IDF and IDF had the higher degree of specificity, lower sensitivity, longer ROC curve distance, less area under the curve to identify CVD than ATPIII and ICO-replaced ATPIII, therefore ICO-replaced IDF and IDF seemed to be undesirable. However, there was no significant difference in area under the curve between ATPIII and ICO-replaced ATPIII in predicting CVD risk. But it seems that odds ratios for abnormal triglyceride and high-density lipoprotein levels increase slightly when using ICO, but decrease for hyperglycemia and hypertension when using ICO.
  
  
  CONCLUSIONS
  ICO was a better predictor of abnormal triglyceride and high-density lipoprotein levels than waist circumference, but waist circumference was a better predictor of hyperglycemia and hypertension than ICO. However, we failed to support ICO as a better parameter for metabolic syndrome definition in predicting CVD risk compared with waist circumference.
authors.affiliation: aChangzhou Center for Disease Control and Prevention, Changzhou bDepartment of Public Health, Soochow University, Suzhou cCenter for Disease Control of Jiangsu Province, Nanjing dCenter for Disease Control of Changshu, Suzhou, Jiangsu, China.
authors.forename: Wenshu
authors.initials: W
authors.lastname: Luo
authors.forename: Zhirong
authors.initials: Z
authors.lastname: Guo
authors.forename: Ming
authors.initials: M
authors.lastname: Wu
authors.forename: Chao
authors.initials: C
authors.lastname: Hao
authors.forename: Zhengyuan
authors.initials: Z
authors.lastname: Zhou
authors.forename: Xingjuan
authors.initials: X
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D014280:Triglycerides