Optimal cut-off values for anthropometric indices of obesity as discriminators of metabolic abnormality in Korea: Results from a Health Examinees study

Abstract Background: Obesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cut-off value for obesity indices to discriminate the presence of a metabolic abnormality as a primary risk for cardiovascular diseases in a Health Examinees study (HEXA). Methods: The 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 (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR), waist circumference (WC), and conicity index (C index). Results: AUC of metabolic abnormality was the highest for WHtR (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 24.3kg/m2 for BMI, 0.887 for WHR, 0.499 for WHtR, 84.4cm for WC and 1.20m3/2/kg1/2 for the C index among men, and 23.4kg/m2 for BMI, 0.832 for WHR, 0.496 for WHtR, 77.0 cm for WC and 1.18m3/2/kg1/2 for the C index among women. Conclusion: Our findings are implicated that the primary prevention of cardiovascular disease can be approached via appropriate recommendations for abdominal obesity in Korea.