Key result
In Japanese patients, the optimal abdominal circumference cutoff levels for predicting metabolic syndrome were 83 cm in males and 78 cm in females, suggesting the current female criterion is too high.
Why the study?
What is the optimal abdominal circumference cutoff for diagnosing visceral obesity in Japanese male and female patients with metabolic syndrome?
Cross-Sectional (n=420)
No
What is the optimal abdominal circumference cutoff for diagnosing visceral obesity in Japanese male and female patients with metabolic syndrome?
The study supports the current Japanese abdominal circumference cutoff for visceral obesity in males (85 cm) but suggests the cutoff for females should be lowered to 78 cm to accurately identify metabolic syndrome.
Supports retaining the male cutoff while questioning the female threshold in Japanese criteria; leaves open prospective validation before any guideline change.
To reappraise the cutoff level of abdominal circumference (AC) for diagnosis of visceral obesity in Japanese, we examined the association of visceral fat deposition with other constituents of metabolic syndrome and atherosclerotic cardiovascular disease (ASCD). CT was used for determination of visceral-fat area (VFA), subcutaneous-fat area (SFA) and AC on CT (AC(CT)) in 420 Japanese patients with (n=180) or without ASCD (n=240). VFA cutoff levels were calculated by receiver operating characteristic (ROC) analysis. AC(CT) correlated with VFA (r=0.828), SFA (r=0.795), and AC measured with an anthropometric tape (AC(M), r=0.96). The VFA cutoff levels yielding the maximum sensitivity and specificity to predict two or more components of metabolic syndrome were 92 cm(2) in males and 63 cm(2) in females, which correspond to AC(M) values of 83 cm and 78 cm, respectively. The male AC(M) cutoff level was similar to the AC in current Japanese criteria (85 cm), but the female AC(M) cutoff level was considerably smaller than the criteria, and this change in cutoff level increased the prevalence of metabolic syndrome in females three-fold. The cutoff levels of VFA for predicting presence of ASCD were 98 cm(2) in males and 75 cm(2) in females, corresponding to AC(M) values of 84 cm and 80 cm, respectively. The present results obtained by CT support the validity of the current Japanese criteria for visceral obesity in males but not in females. AC(M) of 78 cm appears to be a cutoff level suitable for diagnosing visceral obesity in Japanese females, though further confirmation is needed.
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Eguchi et al. (2007) conducted a cross-sectional in Metabolic syndrome (n=420). Visceral fat area and abdominal circumference was evaluated on Cutoff levels of visceral fat area (VFA) and abdominal circumference (AC) yielding maximum sensitivity and specificity to predict two or more components of metabolic syndrome. In Japanese patients, the optimal abdominal circumference cutoff levels for predicting metabolic syndrome were 83 cm in males and 78 cm in females, suggesting the current female criterion is too high.
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