Abstract
BackgroundWe 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.MethodsParticipants 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.ResultsDuring 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.ConclusionData 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2856-9) contains supplementary material, which is available to authorized users.
Highlights
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
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
In Japan, cross-sectional studies have suggested cut-off points of 85–90 cm for men and 77–83 cm for women for predicting the presence of multiple other MetS components [11,12,13], and a recent prospective study showed that the optimal cut-off point of WC for predicting cardiovascular disease (CVD) was 90 cm in men and 80 cm in women [14]
Summary
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. In 2009, a Joint Interim Statement (JIS) criteria was published as a combined effort by a number of international scientific bodies and authorities [8] Besides these international definitions, a Japanese-specific MetS criteria has been proposed by the Japanese Committee of the Criteria for MetS (JCCMS) [10]. A Japanese-specific MetS criteria has been proposed by the Japanese Committee of the Criteria for MetS (JCCMS) [10] These criteria differ in several aspects, including the cut-off points of waist circumference (WC), handling of the WC component (prerequisite or optional for the diagnosis of MetS), and the criteria of hyperglycemia and dyslipidemia. Several prospective studies have examined the ethnic specific WC cut-off values in relation to DM risk among Koreans, Mexicans, and Americans [15,16,17]; no such study has yet been performed in the Japanese population
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