title: Appropriate waist circumference cutoff values for persons with multiple cardiovascular risk factors in Japan: a large cross-sectional study.
abstract: BACKGROUND
  In Japan, the current standard waist circumference cutoff value for persons with multiple cardiovascular risk factors remains controversial. In this study we aimed to analyze the health-check examination data from a large Japanese population and propose a revised waist circumference cutoff value.
  
  
  METHODS
  Subjects of this study were 12,725 adults who underwent a health-check by thorough medical examination between April 2006 and March 2007. Medical examinations included measurement of waist circumference, fasting blood triglycerides, HDL cholesterol, glucose concentrations, blood pressure and collection of demographic characteristics. Receiver operating characteristic (ROC) curve analysis was utilized to find appropriate waist circumference cutoff values in relation to multiple cardiovascular risk factors with two or more of the following: dyslipidemia (hypertriglyceridemia or low HDL cholesterol), hypertension, and hyperglycemia defined by the Japanese criteria of metabolic syndrome.
  
  
  RESULTS
  The average age of the subjects was 50.7 years (standard deviation [SD]: 8.8) for men and 49.7 years (SD: 8.6) for women. ROC curve analysis showed maximum sensitivity plus specificity at a waist circumference of 87 cm in men (0.66 and 0.62, respectively) and 83 cm in women (0.73 and 0.70). When analyzed by ten-year age groups, the ROC curves for younger age groups were shifted up and to the left compared to older age groups, but associations between cutoff values and age were not clear.
  
  
  CONCLUSIONS
  In Japan, the appropriate cutoff value of waist circumference for persons with multiple cardiovascular risk factors is 87 cm for men and 83 cm for women.
authors.affiliation: Department of Nursing, School of Health Sciences, Niigata University, Japan. heart@clg.niigata-u.ac.jp
authors.forename: Sachiko
authors.initials: S
authors.lastname: Narisawa
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kiminori
authors.initials: K
authors.lastname: Kato
authors.forename: Kazumi
authors.initials: K
authors.lastname: Yamada
authors.forename: Juei
authors.initials: J
authors.lastname: Sasaki
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000145:classification* / Q000150:complications / Q000453:epidemiology; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D049629:Waist-Hip Ratio
chemical_list: D008055:Lipids