Comparing validity of using Body Mass Index, Waist to Hip Ratio, and Waist Circumference to Cardiovascular Risk Factors of Middle Aged Koreans

ABSTRACT

This study was conducted to compare the validity of obese index among body mass index(BMI), waist to hip ratio(WHR), and waist circumference(WC) and to determine which is the best in relation to cardiovascular risk factors of middle aged Korean(40-64yr).Data from the 1998 Korean Health and Nutrition Survey were used(N=3380). Anthropometric indices and cardiovascular risk factors were measured. Chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator characteristic(ROC) curves were used in the analysis. There was a significant increasing trend in WHR, systolic blood pressure(SBP), high density lipoprotein cholesterol(HDL), and fasting blood sugar(FBS) with age categories of male and in BMI, WC, WHR, diastolic blood pressure(DBP), SBP, total cholesterol(TC), low density lipoprotein cholesterol(LDL), triglycerol(TG), and FBS with those of female. Specially female had the characteristics of upper body fat and systolic blood pressure risk(p<0.05). Proportions of subjects with lifestyle factors related to cardiovascular risk in overweight or upper body fat group were higher than that of normal group. Higher proportions of subjects were practiced exercise in upper body fat group of male than in other groups. Among 7 cardiovascular risk factors in partial correlation analysis, BMI had the highest correlation coefficient in 6 risk factors in male, whereas WC in 4 risk factors in female. Mean of each obese index according to cardiovascular risk groups except smoker was higher than that of normal(p<0.05). These trends were shown in upper body fat group and female. In ROC analysis of 12 risk factors and health conditions, the largest area under curve among obese indices for risk factors were BMI in male and WHR in female. The optimal cutoff values of each index(BMI: WHR: WC) for one or more cardiovascular risk factors were 23.13: 0.89: 85.35 in male and 23.57: 0.84: 78.35 in female. The results showed that cardiovascular risk factors were prevalent in middle aged Koreans within normal limits of obese indices like another Asians. For the identification of cardiovascular risk factors of middle aged Koreans, BMI for men and WHR for women are appropriate indices. But it is recommended that BMI, WHR, and WC, all three indices should be considered, when using these indices.