Big waistlines ‘best predict’ presence of metabolic syndrome

SINGAPORE — Waistlines of more than 92.5cm for men and 86.5cm for women are the most accurate way to detect Chinese Singaporeans at risk of diseases like Type 2 diabetes and heart disease, suggested a study published recently.

Waist circumference is also more accurate than body mass index and blood pressure in identifying this at-risk group with metabolic syndrome, according to findings from the study.

Metabolic syndrome is the co-occurrence of hypertension, abnormal blood glucose regulation, central obesity (of over 90cm for males and 80cm for females) and abnormal blood lipid levels.

The clustering of these multiple risk factors represents the greatest risk for diseases like diabetes, heart attacks or strokes, said Dr Tan Hong Chang, Associate Consultant at the Singapore General Hospital’s Department of Endocrinology.

The study — published in the May edition of ANNALS, the Academy of Medicine, Singapore’s official medical journal — was authored by a researcher and a psychiatrist, who are both from the Institute of Mental Health (IMH).

It involved 244 Chinese in Singapore aged 21 to 50, of whom 41 were identified to have metabolic syndrome based on established criteria. All had their height and weight, waist circumference, blood pressure and blood samples taken.

The authors — Ms Milawaty Nurjono of IMH’s research division and psychiatrist Jimmy Lee — said the study’s findings cannot be generalised as it included only Chinese subjects who responded to advertisements.

Further study with a larger group of subjects of all age groups is needed to confirm their findings, given the relatively small sample size made up of “generally young individuals”.

The findings cannot be generalised to other ethnic groups as metabolic syndrome risk factors include age, weight, ethnicity and history of concurrent medical problems, said Dr Asim Shabbir, consultant at the National University Hospital’s Centre for Obesity Management and Surgery. Metabolic syndrome is also influenced by one’s genetic make-up and environment, he said.

Dr Asim said individuals who are overweight or obese need to be “more careful” if their waistlines are bigger than the cut-off values found in the study. But hypertension and heart disease also occur in non-obese individuals and the doctors advocated a healthy lifestyle and screening according to an individualised risk-based approach for this group.