Original Article Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrome in postmenopausal women Andre ´ B. Gadelha a , Jonathan Myers b,c , Se ´ rgio Moreira d , Maurı ´lio T. Dutra a , Marisete P. Safons a , Ricardo M. Lima a, * a University of Brası´lia, Brası´lia, Brazil b Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA c Stanford University, Stanford, CA, USA d Federal University of Vale do Sa˜o Francisco, Petrolina, Brazil 1. Introduction The aging process is associated with a decline in most physiological functions; thus, there exists a need for research related to maintaining physical function as the World’s population ages [1]. Important changes that occur with advancing age include fat mass accumulation, which has been consistently linked with impaired cardiometabolic health in older individuals [2]. Moreover, the prevalence of obesity is greater in women, with adiposity accumulation peaking around the fifth decade of life [1,3], coinciding with menopause. Menopause is also associated with reductions in muscle mass and strength, particularly among sedentary women [4], contributing further to increased cardio- metabolic risk. Taken together, the postmenopausal period itself is an independent risk factor for the development of metabolic disorders [5]. The clustering of cardiometabolic risk factors has been referred to as metabolic syndrome (MetS), a complex disorder that is considered a worldwide epidemic [6,7]. The prevalence of MetS has increased and is dependent on sex and age, with a higher incidence reported in postmenopausal women [8]. MetS negatively impacts quality of life, is a major risk factor for cardiovascular disease and has important health care costs implications. Thus, measurement strategies with high predictive accuracy for the identification of MetS are critical to optimally define this syndrome. In this regard, although a variety of adiposity indices have been associated with Diabetes & Metabolic Syndrome: Clinical Research & Reviews xxx (2016) xxx–xxx * Corresponding author at: Universidade de Brası ´lia (UnB), Campus Universita ´ rio Darcy Ribeiro, Faculdade de Educac ¸a ˜o Fı ´sica, Brası ´lia, Distrito Federal 70910-900, Brasil. Tel.: +55 61 84908490; fax: +55 61 31072500. E-mail address: ricardomoreno@unb.br (R.M. Lima). A R T I C L E I N F O Keywords: Metabolic syndrome Obesity Aging Menopause S U M M A R Y Aims: To compare adiposity indices and to assess their various cut-off values for the prediction of metabolic syndrome (MetS) in postmenopausal women. Methods: One hundred forty nine volunteers (67.17  6.12 years) underwent body composition assessment using DXA and had 5 anthropometric indices measured (Waist Circumference, WC; Waist-to- Height Ratio, WHtR; Body Mass Index, BMI; Body Adiposity Index, BAI; and Conicity Index). Blood pressure was assessed using an oscillometric device and fasting blood samples were collected. MetS was classified according NCEP-ATP III. Cut-off values to predict MetS were obtained using Receiver Operating Characteristic (ROC) curve analyses and odds ratios were also calculated. Results: MetS prevalence was 29.5% and subjects who were classified with MetS showed worse cardiometabolic outcomes and higher anthropometric indices values (p < 0.05). With the exception of total- and LDL-cholesterol, all remaining variables were significantly correlated with at least one of the adiposity indices, with the strongest relationships observed for the indices reflecting central body fat. The cut-off values were 88 cm, 0.57 cm/cm, 26.85 kg/m 2 , 43.7%, 36.34%, and 1.24 units for WC, WHtR, BMI, DXA-derived body fat percentage, BAI, and conicity index, respectively. Significant greater risks for MetS were found for volunteers who had WHtR (odds = 9.08; CI: 1.81–45.47) or WC (odds = 5.20; CI: 1.30–20.73) measurements above cut-off values. Conclusion: Adiposity indices are associated with MetS in postmenopausal women in different degrees. Indices which consider central adiposity such as WC and WHtR have a stronger relationship with MetS compared to DXA-derived body fat percentage, which is considered a gold standard. ß 2016 Published by Elsevier Ltd on behalf of Diabetes India. G Model DSX-542; No. of Pages 6 Please cite this article in press as: Gadelha AB, et al. Comparison of adiposity indices and cut-off values in the predictionof metabolic syndrome in postmenopausal women. Diab Met Syndr: Clin Res Rev (2016), http://dx.doi.org/10.1016/j.dsx.2016.01.005 Contents lists available at ScienceDirect Diabetes & Metabolic Syndrome: Clinical Research & Reviews jo ur n al h o mep ag e: www .elsevier .c om /loc ate/d s x http://dx.doi.org/10.1016/j.dsx.2016.01.005 1871-4021/ß 2016 Published by Elsevier Ltd on behalf of Diabetes India.