Comparisons between anthropometric indices for predicting the metabolic syndrome in Japanese

Most definitions of the metabolic syndrome (MS) employ waist circumference as an indicator of central obesity. However, several reports, mainly from Asia, argue that other indices, for example the waist/height ratio, are superior to waist circumference for identifying subjects with cardiovascular risk factors. We therefore investigated correlations between the predictive power of several anthropometric indices and risk factor accumulation (RFA) defined by the existence of two or more disorders among hypertension, dyslipidemia (high triglycerides and/or low levels of high density lipoprotein cholesterol) and fasting hyperglycemia; each of which is a component of MS.

We conducted a cross-sectional analysis using data from a part of the Japan Public Health Center-based Cohort. A total of 315 men and 314 women, 51 to 70 years of age were examined for variables including waist and hip circumferences, blood pressure, fasting plasma glucose and lipids at an annual health check-up.

The prevalence of RFA increased almost linearly in parallel with increasing waist circumference up to 95 cm. Receiver operating characteristic analysis demonstrated that waist circumference was better than waist/ height ratio, waist/hip ratio and BMI at predicting RFA; but the differences were not statistically significant. However, even in the case of waist circumference, no clear cut-off point yields sufficiently high sensitivity and specificity simultaneously.

The predictive power of waist circumference was not inferior to those of other indices. Therefore, waist circumference is practically the most convenient measure for predicting MS because of its simplicity.