Optimal waist circumference cut-off points for predicting Metabolic Syndrome among females of reproductive age in Wakiso district, central Uganda

Abstract Background Metabolic Syndrome (MetS) poses a significant challenge to global public health, due to its strong association with Type 2 diabetes and cardiovascular disease. Waist circumference (WC) is a convenient metric for diagnosing MetS. Our study sought to establish waist circumference cut-offs that predict MetS in females of reproductive age residing in Wakiso district in central Uganda. Methods The data collected were from a cross-sectional study conducted in Wakiso district, central Uganda, involving 697 randomly selected females aged 15 to 49 between June 9 th and August 17 th, 2021. Data included MetS components: WC, High-Density Lipoprotein (HDL) Cholesterol, triglycerides, blood pressure, and fasting blood sugar. MetS status was identified based on two or more MetS components excluding WC. ROC analysis established the average optimal WC. The accuracy and performance of the cut-off points were evaluated through sensitivity, specificity, Positive likelihood ratio, and the Youden index. Results Of the 697 participants, 49.9% had two or more MetS risk factors. For females aged 15-49 years, the average optimal WC cut-off was 80.3 cm. Variations in optimal WC thresholds were observed across different age groups: 97.4 cm for (15-24 years), 79.9 cm (25-34 years), 85.6 cm (35-44 years), and 91.1 cm (45-54 years) respectively. The area under the ROC curve for these age groups ranged from 0.78 to 0.86, indicating good discriminatory capability. The sensitivity ranged from 85% to 97%, specificity from 58% to 88%, and the Youden Index from 0.557 to 0.729. Conclusions A waist circumference of 80.3 cm is the optimal threshold for identifying Metabolic Syndrome in females between the ages of 15 and 49 years in the setting. This finding concurs with the guidance set forth by the International Diabetes Federation. Additionally, study participants had varying WC cut-offs ranging from 79.4 cm to 91.1 cm, depending on their age.