Defining abdominal obesity as a risk factor for coronary heart disease in the US: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Objective: Various organizations have highlighted the need to examine whether abdominal obesity cut-points are appropriate for identification of cardiovascular risk among ethnic minority adults, particularly Hispanic/Latino living in western societies. This study aimed (1) to establish optimal definitions for abdominal obesity among Hispanic/Latinos, and (2) determine the level of agreement between the presence of metabolic syndrome diagnosed by the current Joint Interim Statement (IJS) definition and an updated definition with optimal abdominal obesity cut points.

Research Design and Methods: The sample included 16,289 adults who self-identified as Hispanic/Latino ages 18-74 years enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Receiving operating characteristic (ROC) curves were used to derive sensitivity and specificity values. The largest sum of sensitivity plus specificity was used to determine appropriate cut-points.

Results: Among US Hispanic/Latino adults, waist circumference cut points of >102 cm in men (in line with current IJS criteria) and >97 cm (9 points higher than IJS criteria) in women provide optimal discrimination for cardiovascular risk as judged by the presence of coronary heart disease. When using these cut points to create an updated metabolic syndrome definition among women, we found disagreement between our updated definition and the current IJS criteria. The prevalence of the metabolic syndrome was overestimated by about 5% points among women based on IJS criteria when compared to our definition.

Conclusions: Our results suggest that the current recommendations for waist circumference cut-points may not be appropriate for US Hispanic/Latino women.