Yonsei Med J.  2010 Jul;51(4):511-518. 10.3349/ymj.2010.51.4.511.

Optimal Waist Circumference Cutoff Value Reflecting Insulin Resistance as a Diagnostic Criterion of Metabolic Syndrome in a Nondiabetic Korean Population Aged 40 Years and Over: The Chungju Metabolic Disease Cohort (CMC) Study

• Park YM
• Kwon HS
• Lim SY
• Lee JH
• Yoon KH
• Son HY
• Yim HW
• Lee WC

• KMID: 1805187
• DOI: http://doi.org/10.3349/ymj.2010.51.4.511

Abstract

PURPOSE
We aimed at determining the cutoff value of waist circumference with respect to its ability to reflect insulin resistance in a Korean population.
MATERIALS AND METHODS
A total of 8,817 subjects aged 40 years and over were analyzed. Insulin resistant individuals were defined as those who had the highest quartile value of the homeostasis model assessment of insulin resistance (HOMA-IR) in a non-diabetic population. Receiver operating characteristic (ROC) curve analysis and multiple logistic regression analysis were applied.
RESULTS
The cutoff value of waist circumference reflecting insulin resistance from the ROC analysis was 84.4 cm for men and 80.6 cm for women. Sensitivity and specificity were 70.0% and 54.2% in men and 71.1% and 59.3% in women, respectively. After being controlled for other covariates, the odds ratio for the risk of insulin resistance using < 70 cm of waist circumference as a reference increased significantly in the category of 85.0-89.9 cm for men and 80.0-84.9 cm for women. In addition, statistically significant associations were consistently observed over the category of 85.0-89.9 cm for men and 80.0-84.9 cm for women.
CONCLUSION
The optimal cutoff value for waist circumference reflecting insulin resistance is considered to be 85 cm for men and 80 cm for women, suggesting that the Asian criterion of abdominal obesity (90 cm for men and 80 cm for women) as a component of metabolic syndrome (MetS) might not be applicable for middle-aged to older men in Korea.

Keyword

Metabolic syndrome; waist circumference; insulin resistance

Figure

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  Fig. 1 Scatter plots with regression lines for age-adjusted correlations between waist circumference and homeostasis model assessment of insulin resistance (HOMA-IR) in men (A) and women (B). The degree of correlation was higher in men than women (p= 0.0041).

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  Fig. 2 Receiver operating characteristic (ROC) curves for waist circumference (WC) for reflecting insulin resistance in men (A) and women (B). The cutoff value of WC producing maximum sensitivity plus specificity was 84.4 cm for men and 80.8 cm for women. Sensitivity and specificity were 70.0% and 54.2% in men and 71.1% and 59.3% in women.

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