Diagnostic Accuracy of Waist circumference in detecting metabolic syndrome in type 2 diabetes mellitus patients
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Background: Metabolic Syndrome (MetS) is a constellation of clinical features that increase cardiovascular morbidity and mortality in individuals. Up-to-date, there is no cheap, single surrogate test for MetS and current diagnostic criteria for the syndrome use scoring systems which are laborious, expensive and thus not adaptable to low resource countries such as Zambia. In this study, waist circumference measurement alone was proposed as a simpler surrogate test and thus its diagnostic accuracy for MetS in type 2 Diabetes Mellitus patients was assessed. Objectives: To determine the diagnostic accuracy of waist circumference measurement alone in detecting Metabolic Syndrome (MetS) in type 2 Diabetes Mellitus (Type 2 DM) patients. Materials and Methods: This was a cross-sectional hospital based study of 400 medical outpatients with type 2 DM. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) was used as the standard diagnostic test and components of metabolic syndrome that were measured included waist circumference, blood pressure, fasting blood sugar, fasting serum triglycerides and HDL cholesterol. Abdominal obesity was defined as waist circumference = 94cm for men and =80cm for women. The sensitivity and specificity of waist circumference as compared with the NCEP ATP III definition were determined. Results: The prevalence of MetS was 73% (91% in women and 50% in men; p<0.001).The presence of abdominal obesity had sensitivity of 90% in women and 92% in men and specificity of 86% in women and 91% in men, in detecting metabolic syndrome. The area under the receiver operating characteristic curve was 0.883. Conclusions: There was a high prevalence of MetS among type 2 DM patients in the study. When used alone, waist circumference measurement has a relatively good diagnostic accuracy for MetS in type 2 DM patients. Therefore it can be used alone as a simpler and cheaper surrogate test for diagnosing MetS in type 2 DM patients in resource limited countries.