Statistical Issues on Japanese Criteria of Metabolic Syndrome

Abstract

The article by The Examination Committee of Criteria for ‘Obesity Disease’ in Japan and Japan Society for the Study of Obesity (2002) established cut-off points of waist circumference at 85 cm for males and 90 cm for females as criteria of obesity disease. Their article has also become a basis for criteria of metabolic syndrome in Japan; however, their article has various problems on statistical aspects. How the criteria on waist circumference should vary was investigated through reexamination based on descriptions in their article. First, their article obtained criteria on visceral fat area (VFA) from data in which males and females were pooled, while our reexamination suggested that we should use separate criteria on VFA between males and females. Second, their article inappropriately used regression lines to estimate waist circumference corresponding to VFA cut-off points. Our reexamination with errors-in-variables models suggested alternative cut-off points of waist circumference at 87 cm for males and 85 cm for females. Our simulation confirmed that the criteria by their article might lead to inappropriate diagnosis which is strict for males and easy for females.