Detecting Cardiometabolic Syndrome Using World Health Organization Public Health Action Points For Asians and Pacific Islanders
Andrew Grandinetti, Ph.D.; Joseph K. Kaholokula, Ph.D.; Marjorie K. Mau, M.D., M.S.; Dominic C. Chow, M.D., M.P.H.
Ethnicity & Disease
To assess the screening characteristics of World Health Organization (WHO) body mass index action points for cardiometabolic syndrome (CMS) in Native Hawaiians and people of Asian ancestry (ie, Filipino and Japanese). Design and Setting: Cross-sectional data were collected from 1,452 residents of a rural community of Hawai‘i between 1997 and 2000, of which 1,198 were analyzed in this study. Ethnic ancestry was determined by selfreport. Main Outcome Measures: Metabolic status was assessed using National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria. Screening characteristics of WHO criteria for overweight and obesity were compared to WHO public health action points or to WHO West Pacific Regional Office (WPRO) cut-points. Results: Among Asian-ancestry participants, WHO public health action points improved both sensitivity and specificity for detecting CMS. However, similar improvements were not observed for WPRO criteria for Native Hawaiians. Moreover, predictive values were high regardless of which criteria were utilized due to high CMS prevalence. Conclusions: WHO public health actions points for Asians provide a significant improvement in sensitivity in detection of CMS. However, predictive value, which varies greatly with disease prevalence, should be considered when deciding which criteria to apply. (Ethn Dis. 2010;20:123–128)