| Abstract: | ABSTRACT: BACKGROUND: Abdominal obesity is a more important risk factor than generalised obesity for the development of type 2 diabetes and cardiovascular disease. For preventive and public health purposes it is vital that risk factors are detected as early as possible, in order to affect the lifestyle choices at an individual level. METHODS: We used the data from a community based study assessing the risk for type 2 diabetes and cardiovascular disease and the prevalence of the metabolic syndrome among middle-aged men in Helsinki. From the data we performed sensitivity and specificity analysis including positive and negative predictive values, and corresponding 95% CI for eleven different cut-off points with 1 cm intervals (92 to 102 cm) of waist circumference to identify those with increased risk for type 2 diabetes and/or cardiovascular disease. RESULTS: Waist circumference => 94 cm in middle-aged men, identified subjects with increased risk for type 2 diabetes and/or for cardiovascular disease with a sensitivity of 84.4% (95% CI 76.4% to 90.0%), and specificity of 78.2% (95% CI 68.4% to 85.5%). The respective positive predictive value is 82.9% (95% CI 74.8% to 88.8%), and negative predictive value 80.0% (95% CI 70.3% to 87.1%). CONCLUSIONS: Measurement of waist circumference in middle-aged men is a reliable test to identify individuals at increased risk for type 2 diabetes and cardiovascular disease. This measurement should be used more in daily practice in primary health care to identify individuals at risk and when planning health counselling and interventions. |
