Revised optimal cut-off point of waist circumference for the diagnosis of metabolic syndrome in Japanese women and the influence of height

Tsuyako Shimajiri, Mitsuyo Imagawa, Mika Kokawa, Tomomi Konami, Hitomi Hara, Inbou Kyoku, Emiko Sone, Masayuki Ishigame, Hiroyoshi Kikuoka
Journal of Atherosclerosis and Thrombosis 2008, 15 (2): 94-9

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-height(2) 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 x 100/cm) or waist-to-height(2) (cm x 10,000/cm(2)) ratio, determined as 51 in men and 52 in women, or 30 in men and 33 in women, respectively.

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