Using waist circumference to screen for metabolic syndrome in an inpatient population

Metabolic syndrome (MetS) involves a combination of factors that increases the risk of cardiovascular disease. With no immediate physical symptoms or medical problems associated with this disorder, the diagnosis of MetS is a challenging one. The most widely recognized metabolic criteria (lipid profile, blood pressure, and glucose level) are commonly performed during a hospitalization. The waist circumference (WC) measurement, not a routine component of admission, is not available. Incomplete criteria affect the ability to diagnose MetS and prescribe risk reduction therapy. This study evaluated the efficacy of incorporating WC measurements in screening inpatients for MetS.

Over a 3-month period, 516 adult patients were admitted to medical units at Advocate Lutheran General Hospital in Illinois. A total of 439 (207 men and 232 women) patients were included in this study. Nursing staff measured WC on admission. Additional data elements collected included fasting lipids, fasting plasma glucose, and early morning blood pressures. The prevalence of MetS was calculated using the American Heart Association criteria.

Eliminating high-risk populations from the total sample, 210 (96 men and 124 women) patients remained in the study (refined study population). Of the 210 patients, 78% had an abnormal WC and the prevalence of MetS was found in 158 (75.2%). In men, the prevalence of MetS was 71%, and in women, 78.9%. Only 9 patients did not have an abnormal WC by American Heart Association definition.

Measuring WC in the inpatient population improves the positive predictive value of the MetS diagnostic criteria. The measurement is an easy, inexpensive task to complete, providing complete criteria so that an accurate assessment can be made. Once identified, management of this high-risk group can focus on secondary risk reduction strategies.