Amerindians normalized waist circumference and obesity diagnosis standarized by biochemical and HLA data

Abstract

Metabolic syndrome (MS) and obesity are principal causes of morbidity all over the World, particularly for their association to cardiovascular risk. Amerindians are often living in countries and remote areas with unavailable sophisticated diagnoses methodologies. However, waist-circumference is a reliable and easy to record parameter of visceral obesity and MS. Waist circumference normal values are not yet established in Amerindians: South Asian and Japanese values have been recommended for Amerindian use. The purpose of this study is to objectively define for the first time the waist circumference measure cut-off points for Amerindians. A total of 303 unrelated Amerindian adults recently immigrated to Madrid were studied; they were healthy, since they were questioned and tested as appropriate for blood donation. Waist-circumference was measured in these voluntary blood donors after written consent. Chosen subjects for study had HLA quasi-specific Amerindian genes and not gained weight since their relatively short time living in Spain. Amerindians with Type I or II diabetes or family antecedents were removed from the study. The biochemical parameter used to define normality for MS was the reliable serum HDL-cholesterol levels, whose values are diet independent. A Receiver Operating Characteristic analysis was used to compare the predictive validity and to find out the optimal cut-off points of waist circumference normal values. Cut-off points were ≤88.5 cm in males and ≤82.5 cm in females; these values were close to the median values (88 and 82.2 cm, respectively). Obtained waist circumference values recorded here in normal Amerindians are different to those previously recommended indirectly (those of South Asian/Japanese populations). These parameters may be of great value for American countries health care in order to predict and control MS and its cardiovascular complications. Other countries having a heavy Amerindian immigration (i.e.: USA, Spain) may also benefit for establishing specific Preventive Medicine programs.