Abstract
BackgroundObesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cutoff values for obesity indices to discriminate the presence of metabolic abnormalities as a primary risk factor for cardiovascular diseases in a Health Examinees study (HEXA).MethodsThe current study analyzed 134,195 participants with complete anthropometric and laboratory information in a Health Examinees study, consisting of the Korean population aged 40 to 69 years. The presence of metabolic abnormality was defined as having at least one of the following: hypertension, hyperglycemia, or dyslipidemia. The area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs) were calculated for body mass index, waist to hip ratio, waist to height ratio, waist circumference, and conicity index.ResultsThe AUC of metabolic abnormalities was the highest for waist-to-height ratio (AUC [95% CIs], 0.677 [0.672–0.683] among men; 0.691 [0.687–0.694] among women), and the lowest for the C index (0.616 [0.611–0.622] among men; 0.645 [0.641–0.649] among women) among both men and women. The optimal cutoff values were 24.3 kg/m2 for the body mass index, 0.887 for the waist-to-hip ratio, 0.499 for the waist-to-height ratio, 84.4 cm for waist circumference and 1.20 m3/2/kg1/2 for the conicity index among men, and 23.4 kg/m2 for the body mass index, 0.832 for the waist-to-hip ratio, 0.496 for the waist-to-height ratio, 77.0 cm for the waist circumference and 1.18 m3/2/kg1/2 for the conicity index among women.ConclusionThe waist-to-height ratio is the best index to discriminate metabolic abnormalities among middle-aged Koreans. The optimal cutoff of obesity indices is lower than the international guidelines for obesity. It would be appropriate to use the indices for abdominal obesity rather than general obesity and to consider a lower level of body mass index and waist circumference than the current guidelines to determine obesity-related health problems in Koreans.
Highlights
Obesity is well known as a risk factor for cardiovascular disease
The World Health Organization (WHO) recommended a lower cutoff point of body mass index for Asian populations than for Western populations [6], and it reflects the realization that adverse health is associated with a lower body mass index than the WHO criteria for Western countries [7]
More than half of the participants had at least a single metabolic abnormality of diabetes, hypertension, or dyslipidemia in both men (65.7%) and women (55.7%)
Summary
Obesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cutoff values for obesity indices to discriminate the presence of metabolic abnormalities as a primary risk factor for cardiovascular diseases in a Health Examinees study (HEXA). Recent studies have concluded that waist circumference, waist-to-hip ratio, and waist-to-height ratio better discriminate obesityrelated metabolic abnormalities than body mass index [8,9,10]. We aimed to evaluate the performance of obesity indices and to determine the optimal cutoff values for obesity indices to discriminate the presence of metabolic abnormalities in middleaged Koreans. We comparatively investigated five obesity indices, including body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, and conicity index, in the analyses
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