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DOI: 10.2337/dc06-0739
© 2007 by the American Diabetes Association
Cardiovascular and Metabolic Risk |
Minimum Waist and Visceral Fat Values for Identifying Japanese Americans at Risk for the Metabolic Syndrome
1 Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
2 Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
3 Department of Medicine, University of Washington, Seattle, Washington
4 Department of Anthropology, University of Washington, Seattle, Washington
Address correspondence and reprint requests to Edward J. Boyko, MD, MPH, 1100 Olive Way, Suite 1400, Seattle, WA 98101. E-mail: eboyko{at}u.washington.edu
OBJECTIVE—Japanese American is an ethnic group with a high risk for type 2 diabetes, which is linked to the metabolic syndrome. Central adiposity is considered to play a key role in the metabolic syndrome. Not known are the optimal cut point values for central and visceral adiposity to identify Japanese Americans at risk for the metabolic syndrome.
RESEARCH DESIGN AND METHODS—Study subjects included 639 Japanese Americans. The nonadipose variables of the metabolic syndrome were defined using modified International Diabetes Federation criteria, and the accuracy of identifying at least two of these by intra-abdominal fat area (IAFA) as measured by computed tomography and waist circumference was cross-sectionally assessed using area under receiver operating characteristic (ROC) curves. The values for IAFA and waist circumference that resulted in maximizing the Youden index were defined as "optimal."
RESULTS—The area under the ROC curve for IAFA exceeded that for waist circumference (men 0.787 vs. 0.686; women 0.792 vs. 0.721). For women, the optimal cut points for IAFA and waist circumference were 51.5 cm2 and 80.8 cm (age 
56 years) and 86.3 cm2 and 89.0 cm (age >56 years). For men, the optimal cut points for IAFA and waist circumference were 88.6 cm2 and 90.0 cm (age 57 years) and 96.1 cm2 and 87.1 cm (age >57 years).
CONCLUSIONS—These results argue that current Japanese waist circumference cut points for the metabolic syndrome need to be revised. Moreover, the waist circumference and IAFA cut points should be age specific, especially in women. Appropriate waist circumference cut points are from 80 to 90 cm in women and from 87 to 90 cm in men.
Abbreviations: ATP III, Adult Treatment Panel III • CT, computed tomography • IAFA, intra-abdominal fat area • IDF, International Diabetes Federation • ROC, receiver operating characteristic
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