Should Waist Circumference (WC) be replaced by Index of Central Obesity (ICO) in definition of metabolic syndrome?

Abstract

Waist Circumference (WC) has been widely used as the parameter of central obesity in defining Metabolic Syndrome (MS). Global consensus definition of MS has suggested various race and gender specific cut-offs of WC for quantifying central obesity. We have earlier proposed that using ICO (Index of Central Obesity), the need for race and gender specific cut-offs may be obviated. We propose that WC be supplanted with ICO in all definitions of MS. Using ICO a common cut-off of 0.5 applicable across races and genders might be obtained. Moreover it will enhance the sensitivity of definition by diagnosing subjects who are shorter than general population. Among 258 male and 242 female diabetic patients, subjects with MS (defined as per gender specific WC cut-offs), were found to have a common lower range of ICO suggesting that a common cutoff of WC may be obtained. In another study from NHANES database, replacing ICO with WC was found to enhance the specificity and sensitivity of definition of MS.