Properties of obesity thresholds for detection of HOMA-IR >2 among Cree
| BMI thresholds | Waist circumference thresholds | Waist to hip ratio thresholds | |||||||
|---|---|---|---|---|---|---|---|---|---|
| WHO threshold for obesity, ≥30 kg/m2 | WHO threshold for overweight, ≥25 kg/m2 | ROC-derived threshold, ≥28.5 kg/m2 | ATP III thresholds for abdominal obesity | IDF thresholds for abdominal obesity | ROC-derived threshold | WHO | ROC-derived threshold | ||
| Asian | European | ||||||||
| Women | ≥88 cm | ≥80 cm | ≥80 cm | ≥98 cm | 0.85 | 0.87 | |||
| Sensitivity, % (95% CI) | 79 (75 to 83) | 96 (94 to 98) | 87 (84 to 90) | 97 (96 to 99) | 99 (98 to 1.00) | 99 (98 to 100) | 87 (83 to 90) | 92 (89 to 95) | 87 (83 to 90) |
| Specificity, % (95% CI) | 86 (64 to 97) | 52 (30 to 74) | 86 (64 to 97) | 48 (26 to 70) | 29 (11 to 52) | 29 (11 to 52) | 81 (58 to 95) | 48 (26 to 70) | 81 (58 to 95) |
| Positive likelihood ratio (95% CI) | 5.56 (1.95 to 15.9) | 2.01 (1.28 to 3.15) | 6.11 (2.14 to 17.4) | 1.86 (1.24 to 2.80) | 1.39 (1.06 to 1.82) | 1.39 (1.06 to 1.82) | 4.55 (1.88 to 11.0) | 1.76 (1.17 to 2.65) | 4.55 (1.88 to 11.0) |
| Negative likelihood ratio (95% CI) | 0.24 (0.19 to 0.31) | 0.08 (0.04 to 0.15) | 0.15 (0.11 to 0.20) | 0.05 (0.03 to 0.11) | 0.02 (0.01 to 0.09) | 0.02 (0.01 to 0.09) | 0.16 (0.12 to 0.23) | 0.16 (0.09 to 0.29) | 0.16 (0.12 to 0.23) |
| Men | ≥102 cm | ≥90 cm | ≥94 cm | ≥101 cm | 0.90 | 0.98 | |||
| Sensitivity, % (95% CI) | 70 (64 to 75) | 95 (92 to 97) | 81 (76 to 86) | 82 (77 to 87) | 97 (94 to 99) | 94 (90 to 96) | 85 (81 to 89) | 94 (90 to 96) | 65 (59 to 70) |
| Specificity, % (95% CI) | 91 (78 to 97) | 47 (33 to 61) | 88 (75 to 96) | 82 (68 to 92) | 36 (22 to 51) | 47 (32 to 62) | 80 (65 to 90) | 42 (28 to 58) | 84 (71 to 94) |
| Positive likelihood ratio (95% CI) | 7.51 (2.94 to 19.16) | 1.80 (1.40 to 2.33) | 6.99 (3.06 to 15.96) | 4.64 (2.47 to 8.71) | 1.50 (1.21 to 1.87) | 1.75 (1.33 to 2.31) | 4.27 (2.37 to 7.67) | 1.62 (1.26 to 2.08) | 4.17 (2.10 to 8.28) |
| Negative likelihood ratio (95% CI) | 0.33 (0.27 to 0.41) | 0.10 (0.06 to 0.19) | 0.21 (0.16 to 0.28) | 0.21 (0.16 to 0.28) | 0.09 (0.04 to 0.19) | 0.14 (0.08 to 0.24) | 0.18 (0.13 to 0.25) | 0.15 (0.09 to 0.27) | 0.42 (0.34 to 0.51) |
ATP III, Adult Treatment Panel III; BMI, body mass index; HOMA-IR, Homeostatic Model Assessment-Insulin resistance computed as fasting serum insulin (μU/mL)× fasting plasma glucose (mmol l-1)/22.5; IDF, International Diabetes Federation; ROC, receiver operating curve.