Revised Optimal Cut-Off Point of Waist Circumference for the Diagnosis of Metabolic Syndrome in Japanese Women and the Influence of Height

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 15; no. 2; pp. 94 - 99
• Main Authors: Shimajiri, Tsuyako, Imagawa, Mitsuyo, Kokawa, Mika, Konami, Tomomi, Hara, Hitomi, Kyoku, Inbou, Sone, Emiko, Ishigame, Masayuki, Kikuoka, Hiroyoshi
• Format: Journal Article
• Language: English
• Published: Japan Japan Atherosclerosis Society 2008
• Subjects: Anthropometry - methods; Body Height; Female; Height; Humans; Japan - epidemiology; Male; Metabolic syndrome (MetS); Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Middle Aged; Predictive Value of Tests; ROC Curve; Sex Factors; Waist circumference; Waist-Hip Ratio
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.E540

Aim: We reevaluated waist circumference as a diagnostic criterion of metabolic syndrome (MetS) in Japanese. Methods: We enrolled 5,571 subjects (3,148 men and 2,423 women) who had health check-ups in our center. The criterion was reevaluated using the positive predictive value of a receiver-operating characteristics (ROC) curve at 10 different hypothesized lengths of waist circumference with or without a cluster of risk factors. We also drew ROC curves based on the atherosclerotic findings of clinical examinations. Results: Based on the ROC curves, the optimal waist circumference cut-off was 85 cm in men and 80 cm in women. Using this 80 cm cut-off point in women, misdiagnosis rates of MetS were lowered (-19.1--56.6%) compared to the cut-off point currently in use. Integrating the influence of height, namely by using a waist-to-height2 ratio, misdiagnosis rates in shorter populations were decreased in both men and women. Conclusion: These data suggested an optimal waist circumference cut-off to improve the diagnostic probability of MetS in Japanese women of 80 cm, as well as the utility of an easily detected anthropometric index such as a waist-to-height (cm × 100/cm) or waist-to-height2 (cm × 10,000/cm2) ratio, determined as 51 in men and 52 in women, or 30 in men and 33 in women, respectively.