title: Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among adult Egyptian population.
abstract: OBJECTIVE
  To determine the best anthropometric measurement of obesity, and its optimal cutoff, that best predicts the presence of cardiovascular risk factors among adult Egyptian population.
  
  
  METHODS
  This is a cross-sectional study including a representative randomly chosen sample of the adult Egyptian population from all Alexandria Districts (the second largest governorate in Egypt) based on the multistage random technique. It included 3209 subjects (1567 men, 1642 women) aged 18-80 years from urban and rural areas. The response rate was 80.2%. History, blood pressure, and anthropometric measurements were taken. Laboratory investigations included fasting lipid profile, fasting plasma glucose, and serum uric acid. Different criteria of metabolic syndrome were used and compared. Receiver operator characteristic curve and Youden index were used to determine predictability and cutoffs.
  
  
  RESULTS
  Waist circumference (WC) is the best to predict at least two other components of the metabolic syndrome as defined by the International Diabetes Federation (IDF). The optimal WC cutoffs were 100.5 and 96.25 cm for Egyptian men and women, respectively. The Joint Interim Statement definition (JIS) of metabolic syndrome was the best to predict cardiovascular disease in both genders and diabetes mellitus in women. The prevalence of metabolic syndrome and abdominal obesity was 42.5%, 61%, respectively (ATPIII definition); 43.8%, 61% (American Heart Association definition); 44.3%, 76.4% (IDF definition); 33.8%, 51.7% (IDF definition with Egyptian cutoffs); and 41.5%, 51.7% (JIS with Egyptian cutoffs).
  
  
  CONCLUSIONS
  WC cutoffs in Egyptians differ from those currently recommended. Prevalence of metabolic syndrome and abdominal obesity is high in Egypt, despite being lower on using the Egyptian cutoffs.
authors.affiliation: Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Samir H
authors.initials: SH
authors.lastname: Assaad-Khalil
authors.affiliation: Department of Clinical Pathology, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Magued M
authors.initials: MM
authors.lastname: Mikhail
authors.affiliation: Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Talaat Abdel
authors.initials: TA
authors.lastname: Aati
authors.affiliation: Department of Biostatistics, University of Alexandria, Medical Research Institute, Alexandria, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Zaki
authors.affiliation: Department of Clinical Pathology, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Myriam A
authors.initials: MA
authors.lastname: Helmy
authors.affiliation: Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Magdy H
authors.initials: MH
authors.lastname: Megallaa
authors.affiliation: Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Rehab
authors.initials: R
authors.lastname: Hassanien
authors.affiliation: Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt.
authors.forename: Kamel H
authors.initials: KH
authors.lastname: Rohoma
keywords: Abdominal obesity; Egypt; cutoff point; metabolic syndrome; waist circumference