title: Optimal waist circumference cut-off points and ability of different metabolic syndrome criteria for predicting diabetes in Japanese men and women: Japan Epidemiology Collaboration on Occupational Health Study.
abstract: BACKGROUND
  We sought to establish the optimal waist circumference (WC) cut-off point for predicting diabetes mellitus (DM) and to compare the predictive ability of the metabolic syndrome (MetS) criteria of the Joint Interim Statement (JIS) and the Japanese Committee of the Criteria for MetS (JCCMS) for DM in Japanese.
  
  
  METHODS
  Participants of the Japan Epidemiology Collaboration on Occupational Health Study, who were aged 20-69 years and free of DM at baseline (n = 54,980), were followed-up for a maximum of 6 years. Time-dependent receiver operating characteristic analysis was used to determine the optimal cut-off points of WC for predicting DM. Time-dependent sensitivity, specificity, and positive and negative predictive values for the prediction of DM were compared between the JIS and JCCMS MetS criteria.
  
  
  RESULTS
  During 234,926 person-years of follow-up, 3180 individuals developed DM. Receiver operating characteristic analysis suggested that the most suitable cut-off point of WC for predicting incident DM was 85 cm for men and 80 cm for women. MetS was associated with 3-4 times increased hazard for developing DM in men and 7-9 times in women. Of the MetS criteria tested, the JIS criteria using our proposed WC cut-off points (85 cm for men and 80 cm for women) had the highest sensitivity (54.5 % for men and 43.5 % for women) for predicting DM. The sensitivity and specificity of the JCCMS MetS criteria were ~37.7 and 98.9 %, respectively.
  
  
  CONCLUSIONS
  Data from the present large cohort of workers suggest that WC cut-offs of 85 cm for men and 80 cm for women may be appropriate for predicting DM for Japanese. The JIS criteria can detect more people who later develop DM than does the JCCMS criteria.
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan. hu.huanhuan@yahoo.com.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan. kkurotani@ri.ncgm.go.jp.
authors.forename: Kayo
authors.initials: K
authors.lastname: Kurotani
authors.affiliation: Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan. naoko.sasaki@daimler.com.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan. tai-murakami@jfe-steel.co.jp.
authors.forename: Taizo
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan. ch-shimizu@jfe-steel.co.jp.
authors.forename: Chii
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan. shimizu003@jfe-steel.co.jp.
authors.forename: Makiko
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan. tohru.nakagawa.rh@hitachi.com.
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan. toru.honda.kv@hitachi.com.
authors.forename: Toru
authors.initials: T
authors.lastname: Honda
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan. shuichiro.yamamoto.sr@hitachi.com.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan. hiroko2.okazaki@mitsuichemicals.com.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Okazaki
authors.affiliation: All Japan Labour Welfare Foundation, Tokyo, Japan. satsue_0323@hotmail.com.
authors.forename: Satsue
authors.initials: S
authors.lastname: Nagahama
authors.affiliation: YAMAHA CORPORATION, Shizuoka, Japan. akihiko.uehara@music.yamaha.com.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uehara
authors.affiliation: YAMAHA CORPORATION, Shizuoka, Japan. makoto.yamamoto@music.yamaha.com.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Mitsubishi Plastics, Inc., Tokyo, Japan. tomiken@e-mail.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Azbil Corporation, Tokyo, Japan. t.imai.pz@azbil.com.
authors.forename: Teppei
authors.initials: T
authors.lastname: Imai
authors.affiliation: Azbil Corporation, Tokyo, Japan. a.nishihara.d2@azbil.com.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishihara
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan. mr251764@mr.furukawa.co.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kochi
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan. mr252584@mr.furukawa.co.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Eguchi
authors.affiliation: Nippon Steel & Sumitomo Metal Corporation Kimitsu Works, Chiba, Japan. miyamoto.et9.toshiaki@jp.nssmc.com.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Tokyo Gas Co., Ltd., Tokyo, Japan. horiai1115@gmail.com.
authors.forename: Ai
authors.initials: A
authors.lastname: Hori
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan. kuwahara@ri.ncgm.go.jp.|Teikyo University Graduate School of Public Health, Tokyo, Japan. kuwahara@ri.ncgm.go.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kuwahara
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan. samimarub@ri.ncgm.go.jp.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan. kashino@ri.ncgm.go.jp.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kashino
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan. mr904511@mr.furukawa.co.jp.
authors.forename: Isamu
authors.initials: I
authors.lastname: Kabe
authors.affiliation: Xian Janssen Pharmaceutical Ltd., Shanghai, China. liuzzz6@163.com.
authors.forename: Weiping
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan. mizoue@ri.ncgm.go.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: National Institute of Public Health, Saitama, Japan. kunugita@niph.go.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kunugita
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan. Seitaro.Dohi@mitsuichemicals.com.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Dohi
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D016272:Occupational Health; D011237:Predictive Value of Tests; D012015:Reference Standards; D055105:Waist Circumference; D055815:Young Adult