The use of multiple diagnostic criteria for metabolic syndrome (MetS) may miss high-risk populations for cardiovascular disease. Moreover, since women are more likely to have subcutaneous fat deposits than men, the predictive ability of cardiovascular disease may be improved by optimizing the cut-off value of each component of criteria according to sex and considering whether to include waist circumference (WC) as a required component. In a nationwide cohort of 565,079 men and women from 2008 to 2016 in Japan, we analyzed the association between MetS and each component and the development of CAD, CVD, or CAD/CVD using multivariate Cox regression. Of these 3,934 men (1.19%) and 893 women (0.38%) developed CAD/CVD, with a 1.3- to 2.9-fold increased risk of CAD/CVD when current MetS components were met. The optimal thresholds for predicting CAD/CVD by ROC analysis in men and women were WC 83 and 77 cm, triglycerides 130 and 90 mg/dl, HDL-C 50 and 65 mg/dl, BP 130/80 and 120/80 mmHg, and FPG of 100 and 90 mg/dl, respectively. Although no significant difference was detected between the current MetS criteria and our modified criteria in the ability to predict CAD/CVD, using the new criteria increased prevalence of MetS and significantly improved sensitivity (Table). Optimizing MetS criteria could significantly reduce the number of high-risk individuals overlooked by the current criteria.


Y.Mitsuma: None. Y.Matsubayashi: None. M.Iwanaga: None. T.Yamada: None. K.Kato: None. H.Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Ono Pharmaceutical Co., Ltd., Eisai Co., Ltd., Takeda Pharmaceutical Co., Ltd. K.Fujihara: None. K.Murai: None. T.Sato: None. Y.Yaguchi: None. M.H.Yamada: None. M.Yamamoto: None. T.Osawa: None. M.Kitazawa: None.

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