title: Performance of waist circumference and proposed cutoff levels for defining overweight and obesity in Nigerians.
abstract: BACKGROUND
  Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data.
  
  
  OBJECTIVE
  To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values.
  
  
  METHODS
  Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization's STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P< 0.05.
  
  
  RESULTS
  A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities.
  
  
  CONCLUSIONS
  The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.
authors.affiliation: Department of Medicine, University of Nigeria, Enugu Campus/University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Enugu State, Nigeria.
authors.forename: Christian I
authors.initials: CI
authors.lastname: Okafor
authors.affiliation: Department of Medicine, Ekiti State University/Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria.
authors.forename: Taiwo H
authors.initials: TH
authors.lastname: Raimi
authors.affiliation: Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.
authors.forename: Ibrahim D
authors.initials: ID
authors.lastname: Gezawa
authors.affiliation: Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria.
authors.forename: Anas A
authors.initials: AA
authors.lastname: Sabir
authors.affiliation: Department of Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Cross-River State, Nigeria.
authors.forename: Ofem
authors.initials: O
authors.lastname: Enang
authors.affiliation: Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
authors.forename: Fabian
authors.initials: F
authors.lastname: Puepet
authors.affiliation: Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos, Lagos State, Nigeria.
authors.forename: Olufemi A
authors.initials: OA
authors.lastname: Fasanmade
authors.affiliation: Department of Medicine, University of Nigeria, Enugu Campus/University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Enugu State, Nigeria.
authors.forename: Esther N
authors.initials: EN
authors.lastname: Ofoegbu
authors.affiliation: Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
authors.forename: Olatunde
authors.initials: O
authors.lastname: Odusan
mesh_terms: D000328:Adult; D019540:Area Under Curve; D044383:Black People; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D009765:Obesity / Q000175:diagnosis; D056128:Obesity, Abdominal / Q000175:diagnosis*; D050177:Overweight / Q000175:diagnosis; D012016:Reference Values; D012680:Sensitivity and Specificity; D013851:Thinness / Q000175:diagnosis*; D014505:Urban Population; D055105:Waist Circumference; D055815:Young Adult