Determination of Waist Circumference Thresholds for the Diagnosis of Abdominal Obesity in Adults of African Origin in the Maritime Region of Togo

Abdominal obesity is associated with a major risk of cardiometabolic diseases. The waist circumference thresholds currently used in Togo are based on European data and have not been validated for local African populations. This discrepancy can lead to diagnostic errors and suboptimal management. The objective of this study was to determine the optimal waist circumference thresholds for identifying the cardiometabolic factors characteristic of abdominal obesity. A prospective cross-sectional study was conducted on 506 adults aged 15-59 years in the maritime region of Togo, including 119 subjects without metabolic disease for the establishment of reference intervals. The limits of 2.5 to 97.5 percentiles were used to determine the reference intervals. Biochemical analyses were performed in accordance with ISO 15189 requirements. The diagnostic thresholds associated with the presence of cardiometabolic risk factors were determined by analyzing the ROC curves using the Youden method. In women, waist circumference thresholds of 82, 86, 86 and 91 cm were significantly associated with: Total Cholesterol ≥2.0 g/l, Triglycerides ≥1.50 g/l, Blood Glucose ≥1.00 g/l and BP ≥130/85 mmHg, respectively. The optimal threshold was set at 91 cm. In men, waist circumference thresholds of 71, 73, 74, 82 and 93 cm were significantly associated with: triglycerides ≥1.50 g/l, Blood glucose ≥1.00 g/l, Blood glucose ≥1.26 g/l, Total cholesterol ≥2.0 g/l and blood pressure ≥130/85 mmHg. The optimal threshold selected was 82 cm. This study establishes waist circumference thresholds specific to our black population in the maritime region of Togo: 91 cm for women and 82 cm for men. These values, which are lower than international standards, are significantly associated with the main cardiometabolic risk factors and enable better prevention of metabolic syndrome adapted to local characteristics.