The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study.
BACKGROUND
In Korea, the cutoff values of waist circumference (WC) for the identification of metabolic syndrome (MetS) were suggested to be 90 cm for men and 85 cm for women based on the analysis mainly in middle-aged adults. As aging is associated with increased fat, especially abdominal visceral fat, the cutoff value of WC may differ according to age. In addition, the usefulness of visceral abdominal fat area (VFA) to predict MetS in the elderly has not been studied yet. We aimed to suggest WC and VFA criteria and to compare the predictability of WC and VFA to identify people at risk for MetS.


METHODS
A total of 689 elderly subjects aged>or=63 years (308 men, 381 women) were chosen in this cross-sectional study from an ongoing, prospective, population-based study, the Ansan Geriatric (AGE) cohort study. VFA was measured by single slice abdominal computed tomography scanning. The metabolic risk factors except WC (plasma glucose, blood pressure, serum triglycerides and HDL cholesterol levels) were defined using modified NCEP-ATP III criteria. We estimated the accuracy of VFA and WC for identifying at least two of these factors by receiver operating characteristic (ROC) curve analysis.


RESULTS
Two hundred three of 308 men and 280 of 381 women had >or=2 metabolic risk factors. The area under the ROC curve (AUC) value for VFA to predict the presence of >or=2 metabolic risk factors was not significantly different from that for WC (men, 0.735 and 0.750; women, 0.715 and 0.682; AUC values for VFA and WC, respectively). The optimal cutoff points for VFA and WC for predicting the presence of >or=2 metabolic risk factors were 92.6 cm2 and 86.5 cm for men and 88.9 cm2 and 86.5 cm for women.


CONCLUSIONS
WC had comparable power with VFA to identify elderly people who are at risk for MetS. Elderly Korean men and women had very similar cutoff points for both VFA and WC measurements for estimating the risk of MetS. Age-specific cutoff point for WC might be considered to identify subjects at risk for MetS.
Seo
Ji A
JA
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, 516 Gojan-1-dong, Danwon-gu, Ansan, Gyeonggi-do 425-707, Republic of Korea. seo-ji-a@hanmail.net
Kim
Byoung Gwon
BG
Cho
Hyunjoo
H
Kim
Hye Sook
HS
Park
Juri
J
Baik
Sei Hyun
SH
Choi
Dong Seop
DS
Park
Moon Ho
MH
Jo
Sangmee Ahn
SA
Koh
Young Ho
YH
Han
Changsu
C
Kim
Nan Hee
NH
D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D007723:Korea / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D056128:Obesity, Abdominal / Q000378:metabolism; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference