Purpose: Increased abdominal circumference and body mass index (BMI) are independent cardiovascular risk factor and related preclinical changes on cardiac structure and function. However, there is no comparative study between BMI and waist circumference for deterioration on the functional and structural changes of heart. Therefore, we evaluated what is more predictable component for deterioration on cardiac geometry and function in male Korean rural population. Methods: We analyzed consecutive 1,462 male aged 40–70 years from ARIRANG study. Abdominal circumference and BMI were categorized in tertile and three by three tables were made. All subjects were measured cardiac geometry, systolic and diastolic function by echocardiography. To evaluate the effect of each table on LV mass, LV chamber size, LA size, and diastolic dysfunction, we used logistic regression method for each table with adjust for age, HOMA-IR, systolic blood pressure, and pulse rate. Results: Mean age was 53.5 짹 7.8. Both increasing BMI and waist circumference were significantly increased LV end-diastolic dimension, LV mass index, LV mass to height^2.7, LA volume index and deceleration time of E wave (p<0.01). However, relative wall thickness and LV ejection fraction were showed no statistical significant in both group. In logistic regression model, increasing tertile of BMI was significant predictor of high index LV mass to height^2.7 than abdominal circumference. Increasing tertile of abdominal circumference was significant predictor of increased LV end-diastolic dimension, LA volume and diastolic dysfunction than BMI (Fig. 1). Conclusion: Central obesity is more predictable for diastolic dysfunction, LA and LV enlargements than increased BMI. Increasing BMI is more important factor for LV hypertrophy than increasing waist circumference.