This study investigated which of four different sites of waist circumference (WC) measurement was better associated with a constellation of metabolic risk factors. This cross-sectional study included 1,140 Japanese employees (969 men and 171 women), aged 20-70 years. WC was measured at 1- the narrowest part of the waist; 2- midway between the lowest rib and the iliac crest; 3- the umbilical level and 4- immediately above the iliac crest. Results showed a significant difference in WC according to the site of measurement, especially in women (difference of 3.9 cm in men and 12.6 cm in women). The proportion of individuals who had two or more risk factors was lower in women (12.9%) than in men (43.0%). However, the area under the curve values in identifying 2 or more of the metabolic syndrome components for the four WC measurements were not statistically different for both men and women. Thus, these results suggest that the four WC measurements appear to have similar screening abilities for multiple components of the metabolic syndrome.
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