Our research group found that waist circumference does not effectively predict the existence of metabolic abnormalities in relatively lean Japanese women.17,18 Adipocytokines that are associated with visceral obesity, such as leptin and adiponectin, are associated not only with the pathogenesis of metabolic syndrome but also with that of CKD.27–29 Due to the strong influence of subcutaneous fat, but not visceral fat, on waist circumference,30 the presence of abdominal obesity would not be a useful marker of visceral adiposity in relatively lean Asian women. This evidence concerns the gene ADIPOQ and metabolic syndrome.