Waist Circumference Is an Essential Factor in Predicting Insulin Resistance and Early Detection of Metabolic Syndrome in Adults

Abstract

Background: Metabolic syndrome (Met-S) is considered one of the most important health problems of the 21st century. It includes a group of metabolic disorders that increase the risk of cardiovascular diseases such as overweight and obesity, elevated lipid profile and blood pressure and insulin resistance (IR). Based on the information mentioned above in which there seems to be a relationship between IR and Met-S, the objective of this work was twofold: on the one hand, to assess the relationship between the values of different insulin resistance risk scales and Met-S determined with three different scales, and on the other, to determine whether any of the components of Met-S predispose more to the appearance of IR. Methods: A descriptive cross-sectional study of 418,343 workers. Waist circumference was measured and evaluated together with six formulas to assess the insulin resistance index. Categorical variables were evaluated by calculating the frequency and distribution of each one. For quantitative variables, mean and standard deviation were determined, and Student’s t-test was applied, while for qualitative variables, the chi-square test was performed. The usefulness of the different risk scales for insulin resistance for predicting metabolic syndrome was evaluated using ROC curves, the area under the curve (AUC), as well as their cut-off points for sensitivity, specificity, and the Youden index. Results: People with metabolic syndrome applying any criteria had higher values in the IR risk scales. The different IR scales made it possible to adequately classify people with metabolic syndrome. Of the three definitions of Met-S, the one that showed the greatest relationship with IR was IDF. Conclusions: Most risk scales for insulin resistance enable the presence of metabolic syndrome to be adequately classified, finding the best ones if the International Diabetes Federation (IDF) criteria are applied. Of the elements included in the Met-S, the one that seems to increase the risk of presenting IR the most is waist circumference; hence, the Met-S definition that is most related to IR is that of the IDF, which is the only one of the three in which a high value of waist circumference is necessary to be able to diagnose Met-S. Waist circumference can be considered the central essential component for detecting insulin resistance and, therefore, the early detection of metabolic syndrome.

The newly proposed alanine aminotransferase to high-density lipoprotein cholesterol ratio has shown effectiveness in identifying non-alcoholic fatty liver disease

“…Secondly, let’s continue the analysis based on population characteristics. Generally, older individuals, males, and abdominal obesity individuals tend to have poorer metabolic outcomes ( 50 – 52 ), and in the current study, we found that the proportion of MetS patients among these people was much higher ( Supplementary Table 2 ). Therefore, the higher risk of NAFLD associated with the ALT/HDL-C ratio in these populations may be mediated through other metabolic pathways that contribute to these unfavorable outcomes.…”

Surrogate indices of insulin resistance using the Matsuda index as reference in adult men—a computational approach

“…Different studies have shown marked differences and guidelines for unification criteria in relation to the cutoff values and diagnosis performance for surrogate indices and variables that allow to predict IR, particularly those related to anthropometric measurement, and hormonal and biochemical parameters according to age, race, and ethnicity ( 20 , 52 , 58 – 61 ). Thus, although WC is gender and race/ethnicity specific, its use as a surrogate index for the determination of IR in population studies is limited because it may lead to the underestimation or overestimation of IR prediction; therefore, this index should be adjusted to height for a robust and universal use as a surrogate index for predicting IR ( 20 , 40 , 62 ). Similarly, it is important to highlight that BMI is age, gender, and race/ethnicity specific to predict IR, and countless cutoff values have been described in different population studies; therefore, this index should be carefully applied in personalized medicine rather than in population studies for predicting IR ( 44 , 63 , 64 ).…”

Body Mass Index and Waist Circumference as Predictors of Above-Average Increased Cardiovascular Risk Assessed by the SCORE2 and SCORE2-OP Calculators and the Proposition of New Optimal Cut-Off Values: Cross-Sectional Single-Center Study

“…The study involves a significant number of patients, but it is a very heterogeneous group-therefore, in order to verify the increased cardiovascular risk, we opted to categorize them into smaller groups based on age, gender, and nicotine addiction in accordance with the SCORE2 and SCORE2-OP tables. It is important to mention that we did not collect data on variables like insulin resistance (such as HOMA-IR), which could potentially impact the final findings (waist circumference is sometimes considered an indirect indicator of insulin resistance [33]). A significant drawback of this study is also the lack of additional anthropometric indicators, such as ABSI, Body Roundness Index, Conicity Index, WWI, BMI WC or others (which are known to be beneficial in assessing cardiovascular risk [22,[34][35][36])-nevertheless, this was done on purpose; the mentioned indicators are not typically used in regular clinical practice with patients who have overweight or obesity.…”