Abstract
BackgroundIn this prospective cohort study, we estimated the risk of developing more than 1 metabolic risk factor, using different obesity indices. In addition, we investigated the relative usefulness of the obesity indices for predicting development of such risk factors and calculated optimal cutoffs for the obesity indices.MethodsThe cohort comprised 10 038 representative residents of a small city and a rural county who were recruited in 2001–2002. Follow-up examinations were conducted every 2 years. Among the 3857 participants without metabolic syndrome at baseline, 1102 new cases occurred during the 6-year follow-up. Receiver operating characteristic (ROC) curves for the obesity indices were plotted to compare the usefulness of the obesity indices.ResultsThe numbers of new cases of multiple metabolic risk factors among people in the highest quintiles of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-height ratio at the baseline examination were 2 to 3 times those in the lowest quintiles. The area under the ROC curve for WHR was significantly higher than that for BMI. The optimal BMI cutoff was 24 kg/m2 in men and women, and the optimal WC cutoffs were 80 cm and 78 cm in men and women, respectively.ConclusionsBoth overall obesity and central obesity predicted risk of developing multiple metabolic risk factors, and WHR appeared to be a better discriminator than BMI. To prevent development of metabolic diseases among Koreans, it might be useful to lower the cutoff for abdominal obesity, as defined by WC.
Highlights
Metabolic syndrome is a cluster of interrelated risk factors of metabolic origin that is closely linked to the development of atherosclerotic cardiovascular diseases.[1]
Indices of abdominal obesity such as waist circumference (WC), waist-hip ratio (WHR), and waistheight ratio (WHtR) have been reported to be better discriminators of cardiovascular risk factors than an index of overall obesity such as body mass index (BMI); variations in study design and population ethnicity have led to different conclusions regarding which indices are better discriminators of cardiovascular risk factors.[8,9,10,11]
As compared with the lowest quintile, the risk of developing multiple metabolic risk factors linearly increased for ascending quintiles of the obesity indices in both men and women
Summary
Metabolic syndrome is a cluster of interrelated risk factors of metabolic origin that is closely linked to the development of atherosclerotic cardiovascular diseases.[1]. The definitions of overweight and obesity recommended by the World Health Organization (WHO), based on data from Western populations, are a BMI of 25 kg/m2 or higher and a BMI of 30 kg/m2 or higher, respectively.[4] Because Asians have a higher body fat percentage than whites at the same BMI level,[5,6] lower cutoffs for obesity have been recommended for Asians.[7] Recently, indices of abdominal obesity such as waist circumference (WC), waist-hip ratio (WHR), and waistheight ratio (WHtR) have been reported to be better discriminators of cardiovascular risk factors than an index of overall obesity such as BMI; variations in study design and population ethnicity have led to different conclusions regarding which indices are better discriminators of cardiovascular risk factors.[8,9,10,11]. To prevent development of metabolic diseases among Koreans, it might be useful to lower the cutoff for abdominal obesity, as defined by WC
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