Since no quantitative thresholds exist yet for aboriginal populations, these subjects were also evaluated using the South Asian and Chinese threshold values for waist circumference.
The choice of cutoff values for waist circumference was done according to the recent published consensus, taking into consideration the geographic distribution [ 23].
Clustered metabolic risk was calculated by summing standardised values for waist circumference, triacylglycerol, HbA1c, systolic blood pressure and the inverse of HDL-cholesterol.
Clustered metabolic risk was calculated by summing standardised values for waist circumference, fasting triacylglycerol, insulin and glucose, blood pressure and the inverse of HDL-cholesterol.
Moreover, normative values for waist circumference have not been established for Aboriginal and Torres Strait Islanders (TSI) and these populations differ in a number of metabolic characteristics, relative to fatness [ 7, 20, 21].
They also had higher values for waist circumference, blood pressure, glucose, A1C, insulin, HOMA-IR, total cholesterol, LDL cholesterol, and triglycerides and lower HDL cholesterol concentration (all P < 0.05).
Nonetheless, results on interethnic differences in body fat distribution and phenotype make it reasonable to find different adipokine levels in different ethnic groups, particularly when different cutoff values for waist circumferences have to be considered [ 17].
A number of reports (18– 20) have raised concerns about the threshold values for waist circumference used by the current definitions of abdominal obesity, particularly as applied to Asian, African American, Polynesian, and Hispanic/Latino populations.
A summary score of clustered metabolic risk (zMS) was calculated by summing standardised values for waist circumference, fasting triacylglycerol, HbA1c and systolic blood pressure and the inverse of HDL-cholesterol.
For the IDF definition, we used ethnic-specific cutoff values for waist circumference, i.e. the same criteria for Europid and Sub-Saharan subjects (≥ 94 cm for men and ≥ 80 cm for women) [ 21] and, by extension, for people of 'mixed' descent, and ≥ 90 cm for men and ≥ 80 cm for women of the 4% of participants considered as 'Indian' or 'Chinese'.
