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

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-off points that predict MetS among females of reproductive age in Wakiso district, 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 9th June 2021 and 17th August 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 was 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. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial "N/A" ### Funding Statement DL received funding for this work from the Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and the Strengthening Education and Training Capacity in Sexual and Reproductive Health and Rights (SET-SRHR) Project in Uganda “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Makerere University School of Public Health Higher Degrees Research and Ethics Committee (MakSPH-HDREC) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data already provided as part of the submitted article.