Diagnostic Waist Circumference Thresholds and Abdominal Obesity in Togolese Adults: A Receiver Operating Characteristic Curve Approach

Kafui Codjo Kouassi^{1, 2,} , Hèzouwè Madjalani^{1, 3}, Kossi KODJO^{4, 5}, OURO-BERE Tchagbélé^{1, 6}, BOURAIMA Mouawiyatou⁷, BEBOU Midassirou⁷, Mamatchi MELILA¹ and Tchacondo TCHADJOBO⁸

¹Department of Biochemistry, Faculty of Sciences, University of Lomé, Lomé, Togo

²Biochemistry Unit, University Hospital Campus, Lomé, Togo;Laboratory of Biomedical, Agri-food and Environmental Health Sciences (LaSBASE), University of Lomé, Lomé, Togo

³Laboratory of Biomedical, Agri-food and Environmental Health Sciences (LaSBASE), University of Lomé, Lomé, Togo;Biomedical Laboratory, Polyclinic Wossinu et Gbogbo (POLYCLINELLE), Lomé, Togo

⁴Biochemistry Unit, University Hospital Campus, Lomé, Togo

⁵Transversal Nutrition Unit, Association of Young Intellectuals for Food Security in Togo (JISATOGO), Lomé, Togo

⁶Laboratory of Biomedical, Agri-food and Environmental Health Sciences (LaSBASE), University of Lomé, Lomé, Togo;Biochemistry Unit, Sylvanus Olympio University Hospital Center, Lomé, Togo

⁷Nutrition Division, Ministry of Health, Lomé, Togo

⁸Laboratory of Biomedical, Agri-food and Environmental Health Sciences (LaSBASE), University of Lomé, Lomé, Togo

Cite this paper:
Kafui Codjo Kouassi, Hèzouwè Madjalani, Kossi KODJO, OURO-BERE Tchagbélé, BOURAIMA Mouawiyatou, BEBOU Midassirou, Mamatchi MELILA and Tchacondo TCHADJOBO. Diagnostic Waist Circumference Thresholds and Abdominal Obesity in Togolese Adults: A Receiver Operating Characteristic Curve Approach. American Journal of Food and Nutrition. 2026; 14(4):137-147. doi: 10.12691/ajfn-14-4-1

Abstract

Introduction: Abdominal obesity is a major risk factor for cardiometabolic diseases. The waist circumference thresholds currently used in Togo remain based on European population data. The objective of this study was to determine the optimal waist circumference thresholds for diagnosing abdominal obesity associated with the presence of cardiometabolic risk factors in Togo. Methodology: This cross-sectional study, conducted from 2023 to 2025, involved 834 adults aged 15 to 59 years, drawn from the Black African population residing in Togo. A subgroup of 310 subjects, free of any metabolic pathology, was selected to establish reference intervals. Anthropometric measurements were performed according to a standardized protocol, and biochemical assays in accordance with the requirements of ISO 15189 (2022 version). Receiver Operating Characteristic (ROC) curve analysis was used to determine the optimal threshold values associated with abdominal obesity. Results: The analysis revealed distinct waist circumference thresholds according to sex and the cardiometabolic parameters studied. For triglyceridemia ≥ 1.50 g/L, thresholds reached 93 cm in women versus 73 cm in men, and 87 cm and 71 cm respectively for fasting glucose ≥ 1.00 g/L. The mean optimal thresholds were 93 cm in women and 88 cm in men. These values took into account the waist circumference reference intervals in subjects free of any metabolic pathology. Conclusion: This study established that waist circumference thresholds specific to the diagnosis of abdominal obesity in the Black African population differ from those recommended by the International Diabetes Federation for sub-Saharan Africa. These optimal values would thus allow for a prevention of metabolic syndrome better adapted to the characteristics of the local population.

Keywords:
abdominal obesity waist circumference diagnostic thresholds ROC curves Togo

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