title: The Prevalence of Metabolic Syndrome Using Three Different Diagnostic Criteria among Low Earning Nomadic Kazakhs in the Far Northwest of China: New Cut-Off Points of Waist Circumference to Diagnose MetS and Its Implications.
abstract: BACKGROUND
  Although the epidemic of metabolic syndrome (MetS) has aroused wide public concern, most studies on MetS tend to examine urban and high income settings, and few studies cover nomadic areas and low earning populations. This research aims to investigate the prevalence of MetS and explore the cut-off point of waist circumference in a nomadic minority typical of low income populations in the remote northwest region of China.
  
  
  METHODS
  A cross-sectional study was performed in a representative sample of 3900 Kazakh adults aged 18-84 years from 2009-2010. Three widely used criteria (ATP III\IDF\JIS) were employed to estimate the prevalence of MetS in Kazakhs to compare them with other populations. Receiver operator characteristic (ROC) curve analysis was used to explore the optimal cut-off values of waist circumference.
  
  
  RESULTS
  The age-adjusted prevalence of MetS was 13.8%, 20.9%, and 24.8% based on the ATP III, IDF, and JIS criteria, respectively. The prevalence of MetS was higher in women and increased with age. Except for reduced HDL-cholesterol, the risk of other components of MetS increased with waist circumference enlargement. The cut-off point of waist circumference in screening at least two other components of MetS was 88 cm in men (Sensitivity = 61.1%, Specificity = 62.1%, ROC Curve Distance = 0.54) and 83 cm in women (Sensitivity = 60.0%, Specificity = 59.6%, ROC Curve Distance = 0.57).
  
  
  CONCLUSIONS
  The prevalence of MetS in Kazakhs is higher than the national level of China and falls in between the Euro-American and Asia levels, as their cut-off points of waist circumference differ from that recommended for Chinese. We suggest a cost-effective strategy to screen for MetS and prevent cardiovascular disease using new cut-off points of waist circumference in low earning nomadic Kazakhs.
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Jiaming
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Jingyu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Rulin
authors.initials: R
authors.lastname: Ma
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Yusong
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Jia
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Shangzhi
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Shugang
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Yizhong
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Lati
authors.initials: L
authors.lastname: Mu
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Rui
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Niu
authors.affiliation: Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China.
authors.forename: Shuxia
authors.initials: S
authors.lastname: Guo
mesh_terms: D000328:Adult; D015415:Biomarkers; D001786:Blood Glucose; D002681:China / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids