Research Article Optimal Waist Circumference Cut-Off Point for Multiple Risk Factor Aggregation: Results from the Maracaibo City Metabolic Syndrome Prevalence Study Valmore Bermúdez, 1 Joselyn Rojas, 1 Juan Salazar, 1 Roberto Añez, 1 Mervin Chávez-Castillo, 1 Robys González, 1 María Sofía Martínez, 1 Mayela Cabrera, 1 Clímaco Cano, 1 Manuel Velasco, 2 and José López-Miranda 3 1 Endocrine and Metabolic Diseases Research Center, he University of Zulia, 20th Avenue, Maracaibo 4004, Venezuela 2 Clinical Pharmacology Unit, Jos´ e Mar´ ıa Vargas School of Medicine, Central University of Venezuela, Caracas 1051, Venezuela 3 Lipid and Atherosclerosis Unit, Department of Medicine, Carlos III Institute of Health, IMIBIC/Reina Soia University Hospital/University of C´ ordoba and CIBER Obesity and Nutrition Physiopathology (CIBEROBN), C´ ordoba 230002, Spain Correspondence should be addressed to Valmore Berm´ udez; valmore@gmail.com Received 16 September 2014; Revised 21 November 2014; Accepted 24 November 2014; Published 9 December 2014 Academic Editor: Suminori Kono Copyright © 2014 Valmore Berm´ udez et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Context and Objective. he purpose of this study was to determine optimal waist circumference (WC) cut-of values for the detection of multiple risk factor aggregation in individuals from Maracaibo, Venezuela. Participants and Methods. A total of 1,902 adult individuals of both genders belonging to MMSPS were included. Complete physical, laboratory, and anthropometric examination were done to evaluate Metabolic Syndrome (MS) components and insulin resistance. ROC curves were plotted for risk factor aggregation in order to assess WC cut-of point. Logistic regression models were constructed to assess risk factors associated with the WC. Results. here were 52.2% females and 47.8% males, with WC of 90.7 ± 13.7 cm and 98.2 ± 15.9 cm, respectively. ROC curves exhibited a WC cut-of point for women of 90.25 cm (68.4% sensitivity, 65.8% speciicity) and 95.15 cm (71.1% sensitivity, 67.4% speciicity) for men. HOMA2-IR and high blood pressure were associated with a WC over these cut-of points, as well as 2.5-fold risk increase for multiple risk factor aggregation (OR 2.56; CI 95%: 2.05–3.20;  < 0.01). Conclusions. hese population- speciic WC cut-ofs are readily applicable tools for detection of risk factor aggregation. Insulin resistance is closely associated with this deinition of abdominal obesity, which may serve as a surrogate for its assessment. 1. Introduction Metabolic Syndrome (MS) is a cluster of endocrine-metabolic disturbances which increases the risk of developing Car- diovascular Disease (CVD) and type 2 diabetes mellitus (T2DM) [1]. In recent years its prevalence has increased worldwide, especially in Latin America where it has become a public health issue, fueled by the sociocultural backdrop and psychobiologic habits pertaining to this region [2, 3]. In an attempt to “harmonize” MS diagnostic criteria, organiza- tions such as the International Diabetes Federation, National Heart, Lung, Blood Institute, American Heart Association, and others (IDF/NHLBI/AHA-2009) agreed on an integrated set of diagnostic criteria that may be widely utilized world- wide, and whose clinical application would allow for the identiication of subjects in risk of further cardiometabolic disease [4]. Despite eforts to standardize criteria for this entity, waist circumference (WC) is still the most controversial variable in the MS deinition due to the absence of speciic cut-of points for Latin-Americans, Sub-Saharan Africans, Eastern Mediterranean, and Middle East (Arab) populations. here- fore, when the International Diabetes Federation exposed their criteria for MS diagnosis in 2005 (IDF-2005) [5], they suggested that when using this criterion in South American countries, researchers should rely on cut-of points from Hindawi Publishing Corporation Epidemiology Research International Volume 2014, Article ID 718571, 9 pages http://dx.doi.org/10.1155/2014/718571