title: Sensitivity and Specificity Improvement in Abdominal Obesity Diagnosis Using Cluster Analysis during Waist Circumference Cut-Off Point Selection.
abstract: BACKGROUND
  The purpose of this study was to analyze the influence of metabolic phenotypes during the construction of ROC curves for waist circumference (WC) cutpoint selection.
  
  
  METHODS
  A total of 1,902 subjects of both genders were selected from the Maracaibo City Metabolic Syndrome Prevalence Study database. Two-Step Cluster Analysis (TSCA) was applied to select metabolically healthy and sick men and women. ROC curves were constructed to determine WC cutoff points by gender.
  
  
  RESULTS
  Through TSCA, metabolic phenotype predictive variables were selected: HOMA2-IR and HOMA2-βcell for women and HOMA2-IR, HOMA2-βcell, and TAG for men. Subjects were classified as healthy normal weight, metabolically obese normal weight, healthy and metabolically disturbed overweight, and healthy and metabolically disturbed obese. Final WC cutpoints were 91.50 cm for women (93.4% sensitivity, 93.7% specificity) and 98.15 cm for men (96% sensitivity, 99.5% specificity).
  
  
  CONCLUSIONS
  TSCA in the selection of the groups used in ROC curves construction proved to be an important tool, aiding in the detection of MOWN and MHO which cannot be identified with WC alone. The resulting WC cutpoints were <91.00 cm for women and <98.00 cm for men. Furthermore, anthropometry is insufficient to determine healthiness, and, biochemical analysis is needed to properly filter subjects during classification.
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Valmore
authors.initials: V
authors.lastname: Bermúdez
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Joselyn
authors.identifier: 0000-0003-4994-075X
authors.initials: J
authors.lastname: Rojas
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Juan
authors.identifier: 0000-0003-4211-528X
authors.initials: J
authors.lastname: Salazar
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Roberto
authors.initials: R
authors.lastname: Añez
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Toledo
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Luis
authors.initials: L
authors.lastname: Bello
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Apruzzese
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Robys
authors.initials: R
authors.lastname: González
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Maricarmen
authors.initials: M
authors.lastname: Chacín
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Mayela
authors.initials: M
authors.lastname: Cabrera
authors.affiliation: Endocrine and Metabolic Diseases Research Center, The University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela.
authors.forename: Clímaco
authors.initials: C
authors.lastname: Cano
authors.affiliation: Clinical Pharmacology Unit, José María Vargas School of Medicine, Central University of Venezuela, Caracas 1051, Venezuela.
authors.forename: Manuel
authors.initials: M
authors.lastname: Velasco
authors.affiliation: Lipid and Atherosclerosis Unit, Department of Medicine, Carlos III Institute of Health, IMIBIC/Reina Sofia University Hospital/University of Córdoba and CIBER Obesity and Nutrition Physiopathology (CIBEROBN), 230002 Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: López-Miranda
mesh_terms: D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D055105:Waist Circumference / Q000502:physiology*; D055815:Young Adult