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Background: Cut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individualsat risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly forlarge populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare theability of VFA and WC to predict the presence of ≥2 metabolic risk factors. Methods: We included 36,783 subjects aged 19–79 years undergoing abdominal fat CT during regular health checkupsbetween January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the InternationalDiabetes Federation criteria. Receiver operating characteristic curve analyses were used to determinethe appropriate VFA and WC cut-off values for MetS. Results: VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). Theoptimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age,particularly among women. Conclusion: This large population study proposed the cut-off values for VFA and WC for identifying subjects at riskof MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WCmay be considered.

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