Body Mass Index can Similarly Predict the Presence of Multiple Cardiovascular Risk Factors in Middle-aged Japanese Subjects as Waist Circumference

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Abstract
Objective Adiposity is closely associated with the clustering of metabolic risk factors such as high blood pressure, dyslipidemia, and glucose intolerance. Waist circumference and body mass index (BMI) are the established markers of abdominal adiposity and general adiposity, respectively. However, it has not been examined whether these two markers can detect the clustering of metabolic risk factors in Japanese subjects. Methods and Results We studied 5,796 Japanese middle-aged subjects aged 40-60 years (4,344 males and 1,452 females). Metabolic risk factors including high blood pressure, dyslipidemia, and glucose intolerance were identified according to the diagnostic criteria for metabolic syndrome in Japan. The number of metabolic risk factors was significantly associated with the BMI values in both male and female subjects. The prevalence of subjects with multiple (two or more) metabolic risk factors was 29.4% and 7.6% in males and females, respectively. According to receiver operating characteristic (ROC) analysis, the area under curve values of BMI and waist circumference did not differ in male (0.658 vs. 0.671, p=n.s.) and female (0.776 vs. 0.790, p=n.s.) subjects, indicating that the waist circumference as well as the BMI could be useful in detecting the occurrence of multiple metabolic risk factors. The appropriate cut-off values of BMI to predict the presence of multiple metabolic risk factors were 24.7 and 23.4 kg/m2 in males and females, respectively. The sensitivity and specificity using these cut-off values were 58 and 65% in males and 65 and 77% in females, respectively. Conclusion The BMI values can similarly predict the presence of multiple metabolic risk factors just as the waist circumference in Japanese middle-aged subjects.

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