国际糖尿病联盟代谢综合征诊断标准中的腰围切点分析

目的分析国际糖尿病联盟（IDF）关于代谢综合征（MS）的诊断标准中适用于我国城市中老年人群的诊断中心性肥胖的腰围切点。方法对北京地区中老年人群流行病学调查，无糖尿病者行口服75g葡萄糖耐量试验，同时进行问卷调查和体检。对1870例完整资料进行统计，通过对腰围预测各代谢异常危险因素的分析，讨论适用于该人群的诊断中心性肥胖的腰围切点。结果（1）无论男性还是女性，甘油三酯（TG）、收缩压、舒张压和空腹血糖（FBG）的中位数均随腰围的增加而呈线形增加趋势，高密度脂蛋白胆固醇（HDL-C）呈线形下降趋势；（2）高TG、高血压、高FBG、低HDL-C及≥2个危险因素的患病率随腰围的增加而增加；（3）腰围预测各代谢异常因素的敏感度和特异度、ROC曲线，以及Youden指数均显示男性腰围90cm，女性腰围80cm时预测各代谢异常因素的真实性较好；（4）预测≥2个代谢异常危险因素的OR值在男性腰围≥90cm，女性≥80cm时增加最为显著。结论北京城市中老年人群中男性腰围90cm，女性80cm是IDF诊断MS的标准中诊断中心性肥胖的合适切点。     

1677例老干部向心性肥胖和心血管病危险因素的关系

目的　调查分析军队退休老干部群体向心性肥胖及其与心血管病危险因素的关系。方法　根据计划方案对成都地区 6 0岁以上军队退休老干部进行病史询问和体格检查 ,获得完整资料 16 77份。对腰围和体重指数 (BMI)、高血压、糖尿病、高胆固醇血症、高甘油三酯血症等心血管病危险因素进行分析。结果　BMI在男性和女性分别为2 4 .4 2± 3.0 4和 2 3.97± 3.12 (P >0 .0 5 )。腰围在男性和女性分别为 (83.79± 8.34)cm和 (78.4 3± 7.89)cm(P <0 .0 0 1) ,并呈现随年龄增长而增大的趋势。腰围过大者占总体的 4 7.88% ;腰围与BMI正相关 ,但 2 9.5 2 %的腰围过大者其BMI<2 5 ;对腰围进行分层处理后 ,可见除高胆固醇以外 ,各危险因素及危险因素聚集 (具有 2个及以上危险因素 )的检出率随腰围的增大而逐渐上升 ,呈密切的正相关。结论　军队退休老干部反映向心性肥胖的指标———腰围与心血管病危险因素及其分布情况密切相关     

中心性肥胖的腰围切点分析

正肥胖是心血管疾病等慢性疾病的重要危险因素,中心性肥胖,又称腹型肥胖,与慢性疾病有关联。中心性肥胖最常用的指标是腰围,2000年世界卫生组织针对亚洲及太平洋地区人群,临床建议了诊断中心性肥胖的腰围切点(男性≥90cm,女性≥80cn),并强调各国应根     

北京社区2型糖尿病患者颈围与中心性肥胖及代谢综合征的相关性

目的探讨颈围与中心性肥胖及代谢综合征(MS)的相关性。方法在北京城区整群抽样,纳入2型糖尿病及糖尿病前期患者3191例,男性1 249例,女性1 942例。检测身高、体重、颈围、腰围、臀围、血压、血糖、血脂,并进行分析。结果总体人群的颈围(36.5±3.8)cm;男性和女性患者颈围与腰围、体重指数、腰臀比、血压和TG均呈显著正相关,与HDLC呈显著负相关;在调整MS相关因素后,颈围仍为MS的独立危险因素。男性颈围与中心性肥胖和MS诊断的ROC曲线下面积分别为0.747和0.725,最佳切点值均为38.5 cm;女性颈围与中心性肥胖和MS诊断的ROC曲线下面积分别为0.742和0.688,最佳切点值分别为34.5 cm和34.7 cm。结论颈围是反映中心性肥胖的有效指标;颈围粗是MS的独立危险因素,对MS的发生具有预测能力。     

中国成人代谢综合征腰围切点的研究

目的　根据中国成人较近期的调查数据 ,分析代谢综合征中腰围的适宜切点。方法　利用国家“九五”科技攻关课题 1998年在 15组人群进行心血管病危险因素调查 13732例 35～ 5 9岁成人的数据库 ,分析男性和女性不同腰围水平和代谢综合征其他成分聚集的关系 ,并寻找检出两个及以上危险成分假阳性和假阴性率均较低的腰围切点 ,作为成人腰围切点的建议。据此计算各性别年龄组代谢综合征的患病率 ,以及成分组合特点。结果　随腰围增大 ,代谢综合征成分聚集的OR值显著增高 ,以男性腰围≥ 85cm ,女性腰围≥ 80cm ,ROC曲线距离最短。以此为腰围切点中年男性人群代谢综合征患病率为 19 3% ,女性为 13 9% ,其中以腰围超标 ,血压升高和高甘油三酯三项的组合为最多。结论　建议男性腰围≥ 85cm ,女性腰围≥ 80cm ,收缩压≥ 130mmHg(1mmHg =0 133kPa)和 (或 )舒张压≥ 85mmHg ,血清甘油三酯≥ 1 6 9mmol/L ,高密度脂蛋白胆固醇 <1 0 3mmol/L ,空腹血糖≥ 6 1mmol/L ,5项中具备 3项及以上作为中国成人代谢综合征的临床检出标准。以上初步结果需要在有全国代表性的样本中进一步验证。     

代谢综合征

代谢综合征是指中心型肥胖、高血压、高密度脂蛋白胆固醇降低、甘油三酯升高和血糖升高等几个容易同时存在的因素的组合，可增加糖尿病和心脑血管病的危险。代谢综合征者由于有多种危险因素聚集，因而属于高危人群。美国关于代谢综合征的定义是：腹型肥胖（腰围男性大于102cm，女性大于88cm），高血压（高于130／85mm Hg），糖尿病或糖耐量受损（空腹血糖大于6．1mmol／L）、血脂异常（甘油三酯大于1．7mmol／L，     

太原地区3883名体检者心血管疾病危险因素分析

目的 分析太原地区3 883名体检者心血管疾病危险因素,探讨心血管危险因素分布的特征和规律,并评价各种肥胖指标预测心血管危险因素的价值.方法 2005年-2006年太原市区两个社区自然人群体检对象中资料完整的成人3 883名.调查以健康体检形式进行,测量身高、体重、腰围、臀围和血压,计算体重指数(BMI)和腰臀围比值.空腹抽取静脉血,测定血糖和血脂.将男性和女性按年龄分为6个年龄段进行统计分析,分析不同年龄段各心血管危险因素分布情况.人群中未进行降糖、降压、调脂治疗的2 817名各心血管危险因素进行相关分析及因子分析.对不同腰围分别计算预测血脂异常、高血压、高空腹血糖(FBG)及≥2 个心血管危险因素的灵敏度和特异度,计算Youden指数.结果 男性随年龄增加腰围、血糖、血压、血脂异常所占比例增加,腰臀比值异常所占比例随年龄呈升高趋势,各年龄组间有统计学意义(P<0.05);体重指数异常所占比例随年龄增加升高趋势不明显.女性随年龄增加腰围、血压、血脂异常所占比例增加,各年龄组间有统计学意义(P<0.05);血糖异常、腰臀比值异常、体重指数异常所占比例在≤70岁各年龄段随年龄增加而增加.男女血糖、血压、血脂异常所占比例无明显差别.女性40岁后腰围超标者高于男性.各心血管危险因素Pearson相关分析显示,这些指标间大多存在两两相关.其中腰围、BMI、腰臀围比值与其他指标有较强相关性.采用因子分析可见腰臀围比值、腰围、BMI这些肥胖因子为核心因子,没有一个变量同时连接所有因子.因子负荷数值腰围＞腰臀围比值＞体重指数.根据腰围预测各心血管危险因素的敏感度和特异度、ROC曲线,以及Youden指数均显示男性腰围85 cm,女性腰围75 cm时预测各心血管危险因素的真实性较好.根据腰臀比值预测各心血管因素的敏感度和特异度、ROC曲线,以及Youden指数均显示男性腰臀比值0.90,女性腰臀比值0.80时预测各心血管危险因素的真实性较好.结论 各心血管危险因素异常所占百分比随年龄有递增趋势,且男女各有特点.肥胖处于各危险因素的核心位置,肥胖指标中以中心性肥胖为肥胖诊断标准,尤其腰围诊断价值较高.太原城市人群中男性腰围85 cm,女性75 cm或腰臀比值男性0.90,女性0.80 可能是诊断中心性肥胖的合适切点.     

上海市奉城社区30岁以上人群代谢综合征腰围切点的研究

目的：分析上海农村30岁以上人群代谢综合征（MS）腰围的适宜切点。方法：随机整群抽取上海市奉贤区奉城镇灯民村及洪南村30岁以上人群1041人。分析男性和女性不同腰围水平与MS其他成分聚集的关系，并寻找检出2个及以上危险成分假阳性和假阴性率均较低的腰围切点，作为30岁以上人群腰围切点的建议。据此计算各性别年龄组MS的患病率以及成分组合特点。结果：随腰围增大，MS成分聚集的比数比（0R）显著增高，以男性腰围≥85．0cm．女性腰围≥80．0cm．接受者运行曲线（ROC）距离最短。以此为腰围切点，30岁以上人群男性MS患病率为15．32％，女性为12．35％．其中以腰围超标、血压升高和高血糖3项的组合为最多。结论：建议男性腰围≥85．0cm，女性腰围≥80．0cm，收缩压≥130mmHg（1mmHg=0．133kPa）和（或）舒张压≥85mmHg，血清三酰甘油（TG）≥1．7mmol／L，男性高密度脂蛋白胆固醇（HDL—C）〈1．03mmol／L、女性HDL—C〈1．29mmol／L，空腹血糖（FBG）≥5．6mm01／L，5项中具备3项及以上作为上海农村MS的临床检出标准。     

北京社区超重及肥胖居民心血管病生物学危险因素聚集现状分析

目的分析北京社区超重及肥胖人群的心血管病生物学危险因素聚集情况。方法 2007年6月至8月对9786例"社区居民胆固醇教育及控制"项目受调查者资料进行分析。按体重指数(BMI)将受调查者分为正常体重、超重及肥胖3类人群;根据体格检查及晨起空腹血浆化验结果,评价3类人群心血管病生物学危险因素聚集情况。结果 (1)存在2个及2个以上生物学危险因素的个体分别占正常体重、超重及肥胖人群的10.5%、22.5%和37.9%,平均BMI每增加1,个体发生心血管病生物学危险因素聚集的风险增加21%。超重及肥胖男性患生物学危险因素聚集风险高于同BMI水平女性(P均0.001);(2)青年、中年及老年男性肥胖者中,生物学危险因素聚集者所占比例为49.2%,49.7%和56.1%(P=0.285);上述3类女性肥胖者生物学危险因素聚集者所占比例分别为16.9%,35.7%和48.6%;(3)危险因素聚集组分最常见组合为"高血压+血脂异常",分别占男性超重和肥胖者的21.7%和38.7%,及女性超重及肥胖者的18.4%和25.5%。结论北京社区超重及肥胖者存在心血管病生物学危险因素聚集的风险明显高于正常体重人群;而在肥胖人群中,中青年男性与老年男性已具有相同危险性,故应将超重及肥胖人群,尤其是其中青年男性群体作为早期预防干预的重点对象,从而从上游预防心血管事件发生。     

中老年人群高甘油三酯血症-腰围表型与心血管危险因素聚集关系探讨

目的:探讨40~79岁中老年人群高甘油三酯(TG)血症-腰围(HTWC)表型与心血管危险因素聚集的关系。方法 :利用2013年成都市4个社区横断面流行病学调查的1 004例40~79岁中老年人群数据,将HTWC定义为TG≥2.0 mmol/L,男性腰围≥90 cm,女性腰围≥85 cm。分为(1)TG和腰围正常组(492例)即血TG2.0 mmol/L,男性腰围90 cm,女性腰围85 cm;(2)单纯腹型肥胖组(301例)即血TG2.0 mmol/L,男性腰围≥90 cm,女性腰围≥85 cm;(3)单纯高TG组(79例)即血TG≥2.0 mmol/L,男性腰围90 cm,女性腰围85 cm;(4)HTWC组(132例)即血TG≥2.0 mmol/L,男性腰围≥90 cm,女性腰围≥85 cm,共4组。分析该人群HTWC检出率及其与心血管危险因素聚集的相关性。结果:40~79岁中老年人群HTWC表型的检出率为13.15%(男性12.69%,女性13.37%),40~79岁人群中HTWC组心血管危险因素聚集检出率为41.67%,而TG和腰围正常组心血管危险因素聚集检出率为13.21%。多因素Logistic逐步回归分析显示,经校正年龄、性别、体重指数、吸烟史、糖尿病家族史及高血压家族史后,HTWC组发生心血管危险因素聚集的检出率仍为TG和腰围正常组的4.50倍(比值比:4.50,95%可信区间:2.84~7.12,P0.05)。结论:中老年人群HTWC与心血管危险因素聚集密切相关,可作为筛查心血管危险因素聚集的指标。     

Relationships between indices of obesity and its cardiovascular comorbidities in a Chinese population.

BACKGROUND: Current definitions of overweight/obesity and central adiposity guidelines are based on Western populations, and may not be appropriate for the Chinese population. More data among Chinese are needed to address this issue. We aimed to identify cut-offs for body mass index (BMI) and waist circumference that confer increased risk of cardiovascular disease in a Chinese population in Shanghai. METHODS AND RESULTS: A representative, cross-sectional sample of 13,817 adults aged >18 years was studied in Shanghai. In men and women, blood pressure (systolic and diastolic), total cholesterol, low-density lipoprotein-cholesterol, triacylglycerol, and glucose values were incrementally higher and mean high-density lipoprotein-cholesterol values were incrementally lower with increased BMI and waist circumference. Both the point at which sensitivity equaled specificity and the shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or >or=2 of these risk factors generally suggested a BMI cut-off value of 24 kg/m(2) for both men and women, and a waist circumference cut-off value of 85 cm for men and 80 cm for women. CONCLUSIONS: A BMI cut-off of 24 kg/m(2) for both men and women, and a waist circumference cut-off of 85 cm for men and 80 cm for women might be appropriate for use in identifying adults at high risk of developing cardiovascular disease and serve as public health action thresholds in Shanghai residents.     

蒙古族农牧民代谢综合征诊断的腰围切点观察

目的研究我国蒙古族农牧民代谢综合征（MS）诊断的腰围（WC）适宜切点。方法以内蒙古自治区通辽市科左后旗朝鲁吐苏木和奈曼旗固日班花苏木32个自然村2589名年龄大于20岁的蒙古族农牧民为研究对象,以国际糖尿病联盟（IDF）MS全球共识诊断标准为基础,分析蒙古族男女不同WC水平与MS其他组分聚集的关联,检出至少两个组分存在时灵敏度和特异度均较高的WC界限,作为诊断蒙古族农牧民MS的WC切点,并以此计算不同年龄组MS的检出率。结果随WC增大,MS组分聚集的OR值显著增高。当男性WC≥84cm、女性WC≥81cm时,ROC曲线下面积最大。结论IDF标准在蒙古族农牧民男性中WC切点偏高,宜降至男性≥85cm、女性≥80cm。     

中国成人多重心血管危险因素聚集的最佳腰围切割点

目的探讨中国成人多重心血管危险因素聚集的最佳腰围切割点。方法分析1994年全国糖尿病普查的15628例年龄≥25岁的中国成人资料。以腰围〈70cm组（每隔5cm分为一组）作为对照,计算其他各组发生多重心血管危险因素的优势比OR值和95％CI。采用ROC曲线分析计算不同腰围水平对多重心血管危险因素聚集识别的敏感性和特异性,以诊断指数（诊断指数=1-假阳性-假阴性）最大的腰围作为最佳切割点。结果无论男性还是女性。胰岛素抵抗、血脂异常、高血压和高血糖的百分比均随着腰围的增加而增加。男性腰围≥85cm、女性腰围≥80cm后发生代谢综合征的OR值显著增加[分别为2．08（95％CI1．80-2．39）和1．66（95％CI1．41-1．97）1。ROC分析显示以上相应腰围切割点具有最佳的敏感性和特异性。结论反映中国成人多重心血管危险因素聚集的男性最佳腰围切割点为85cm、女性为80cm。     

Appropriate waist circumference cutoff points for central obesity in Korean adults

BACKGROUND: The International Diabetes Federation consensus recently proposed a new definition for the diagnosis of metabolic syndrome, incorporating ethnically specific waist circumference (WC) cutoff points. OBJECTIVE: We investigated the ethnically appropriate WC cutoff values for central obesity in Korean adults to predict increased risk of elevated triacylglycerol, reduced HDL cholesterol, elevated blood pressure, elevated fasting plasma glucose, or two or more of these factors. DESIGN: We used data from 6561 adults, aged 20-80 years, who participated in the Korean Health and Nutritional Examination Survey of 1998, a cross-sectional health survey of a nationally representative sample of Koreans. RESULTS: Based on the receiver operating characteristic curve analysis, the WC value for predicting metabolic risk factors in Koreans was about 85 cm for men and 80 cm for women. The odds ratio for the risk of two or more metabolic risk factors increased abruptly in men with WC >or= 90 cm and women with WC >or= 85 cm. The 80th percentile for WC in the Korean population was 90 cm for men and 86.5 cm for women. Thus, the appropriate WC cutoff point for central obesity in Koreans was determined to be 90 cm for men and 85 cm for women. CONCLUSIONS: Based on our criteria, the prevalence of central obesity was 19.8% in Korean men and 24.5% in Korean women. These findings suggest the applicability of ethnically specific cutoff points for WC in assessing central obesity.     

Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993-2009

The objective of this study is to examine the trends in body mass index (BMI), waist circumference (WC) and prevalence of overweight (BMI 25-27.49 kg m(-2) ), general obesity (BMI ≥ 27.5 kg m(-2) ) and abdominal obesity (WC ≥ 90 cm for men and ≥80 cm for women) among Chinese adults from 1993 to 2009. Data were obtained from the China Health and Nutrition Survey, which was conducted from 1993 to 2009 and included a total of 52,621 Chinese adults. During the period of 1993-2009, mean BMI values increased by 1.6 kg m(-2) among men and 0.8 kg m(-2) among women; mean WC values increased by 7.0 cm among men and 4.7 cm among women. The prevalence of overweight increased from 8.0 to 17.1% among men (P < 0.001) and from 10.7 to 14.4% among women (P < 0.001); the prevalence of general obesity increased from 2.9 to 11.4% among men (P < 0.001) and from 5.0 to 10.1% among women (P < 0.001); the prevalence of abdominal obesity increased from 8.5 to 27.8% among men (P < 0.001) and from 27.8 to 45.9% among women (P < 0.001). Similar significant trends were observed in nearly all age groups and regions for both men and women. The prevalence of overweight, general obesity and abdominal obesity among Chinese adults has increased greatly during the past 17 years.     

Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.     

Prevalence of obesity and metabolic syndrome in Korean adults

We studied the prevalence and trend of obesity and metabolic syndrome in Korean adults aged at least 20 years using Korean National Health Examination and Nutrition Survey data from 1998 and 2001. The prevalence of body mass index (BMI) ≥ 25 kg m^?2 among Korean adults in 2001 was 32.9% in men and 27.4% in women, and the number of Korean men with BMI ≥ 25 kg m^?2 has increased markedly since 1998. A significant positive association between obesity and socioeconomic status was found in Korean men, whereas a significant negative association was identified in Korean women. The prevalence rates of waist circumference (WC) ≥ 90 cm in men and WC ≥ 85 cm in women were 23.4% and 23.1% in 2001 respectively. The prevalence of metabolic syndrome among Korean adults was 15–30% according to various criteria of metabolic syndrome. Future studies are needed to determine the changes in prevalence of obesity and contributing factors for obesity in Koreans.     

Microalbuminuria in relation to the metabolic syndrome and its components in a Chinese population

Background

Although the positive relationship between insulin resistance (IR) and central obesity is well known, the direct relationship between waist circumference and IR is not clear yet and there is no consensus regarding the cut off value for waist circumference as a surrogate index for central obesity. The present study was aimed to determine the optimal cut-off value of waist circumference (WC) for predicting IR in reproductive aged Iranian women.

Methods

Using the stratified, multistage probability cluster sampling method 1036 women were randomly selected from among reproductive aged women of different geographic regions of Iran. Following implementation of exclusion criteria, complete data for 907 women remained for analysis. Insulin resistance was evaluated by the homeostasis model assessment (HOMA-IR) and its cut off value was defined as the 95th percentile of HOMA-IR value for 129 subjects, without any metabolic abnormality. The optimal cut-off of WC in relation to HOMA-IR was calculated based on the receiver operating characteristics (ROC) curve analysis using the Youden index and the area under curve (AUC).

Results

The mean age of the total sample of 907 subjects was 34.4 ± 7.6 years (range, 18 - 45 years). After adjustment for age the odds ratios (OR) of elevated HOMA-IR were progressively higher with increasing levels of waist circumference; the age adjusted OR of IR for women with WC > 95 cm in comparison to those subjects with WC < 80 cm, was 9.5 (95% CI 5.6-16.1). The optimal cutoff value for WC predicting IR was 88.5 cm; with a sensitivity and specificity of 71% and 64%, respectively.

Conclusions

Waist circumference is directly related to insulin resistance and the optimal cut-off value for waist circumference reflecting insulin resistance is considered to be 88.5 cm for reproductive aged Iranian women.     

Waist circumference cut-off points for identification of abdominal obesity among the tunisian adult population

AIMS: Waist circumference (WC) is a convenient measure of abdominal adipose tissue. It itself is a cardiovascular disease (CVD) and diabetes-risk factor and is strongly linked to other CVD risk factors. There are, however, ethnic differences in the relationship of WC to the other risk factors. The aim of this study was to determine the optimal cut-off points of WC and body mass index (BMI) at which cardiovascular risk factors can be identified with maximum sensitivity and specificity in a representative sample of the Tunisian adult population and to investigate any correlation between WC and BMI. METHODS: We used a sample of the Tunisian National Nutrition Survey, a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. WC, BMI, blood pressure and fasting blood measurements (plasma glucose, total cholesterol, triglycerides) were recorded. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of WC and BMI to identify with maximum sensitivity and specificity the detection of high blood pressure, hyperglycaemia, high blood cholesterol and hypertriglyceridaemia. RESULTS: ROC curve analysis suggested WC cut-off points of 85 cm in men and 85 cm in women for the optimum detection of high blood pressure, diabetes and dyslipidaemia. The optimum BMI cut-off points for predicting cardiovascular risk factors were 24 kg/m(2) in men and 27 kg/m(2) in women. The cut-off points recommended for the Caucasian population differ from those appropriate for the Tunisian population. The data show a continuous increase in odds ratios of each cardiovascular risk factor, with increasing level of WC and BMI. WC exceeding 85 cm in men and 79 cm in women correctly identified subjects with a BMI of >/=25 kg/m(2), sensitivity of >90% and specificity of >83%. CONCLUSIONS: Based on the ROC analysis, we suggest a WC of 85 cm for both men and women as appropriate cut-off points to identify central obesity for the purposes of CVD and diabetes-risk detection among Tunisians. WCs of 85 cm in men and 79 cm in women were the most sensitive and specific to identify most subjects with a BMI >/=25 kg/m(2).