Korean J Fam Pract. 2018; 8(3): 335-340  https://doi.org/10.21215/kjfp.2018.8.3.335
The Relationship between Body Fat Percent and Obesity Indices in Adults and Waist-to-Height Ratio as a Screening Tool of Cardiovascular Risk Factor
EoJin Kim, Yu-Lee Kim*, Yongjae Jeong, Jaehoon Jung
Department of Family Medicine, Busan Medical Center, Busan, Korea
Yu-Lee Kim
Tel: +82-51-607-2179, Fax: +82-51-507-3001
E-mail: 07721052@hanmail.net
ORCID: http://orcid.org/0000-0002-6371-2609
Received: May 10, 2017; Revised: August 30, 2017; Accepted: September 6, 2017; Published online: June 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Obesity is a predisposing risk factor for cardiovascular disease (CVD). Body mass index (BMI) is a commonly used indicator to assess obesity. The objective was to evaluate the relationship between body fat (BF) percentage and three obesity indicators: BMI, waist circumference (WC), and waist circumference to height ratio (WHtR). We also analyzed the waist-to-height ratio as a screening tool for CVD risk factors.
Methods: The Korea National Health and Nutrition Examination Survey in the Korean population was conducted from 2009 to 2011. We surveyed 8,013 men and 10,161 women aged 19 years or older. We investigated the BF percentage, BMI, WC, and WHtR. We analyzed the relationship between the WHtR and the prevalence of CVD risk factors. We analyzed odds ratios of CVD risk factors according to the WHtR groups.
Results: There was a statistically positive correlation between BF percentage and the obesity indices. There were strong associations of increasing WHtR with the prevalence of CVD risk factors. The three obesity indicators were statistically significant in predicting CVD risk factors. There was a strong correlation between increased WHtR and increased prevalence of CVD risk factors.
Conclusion: The cutoff value for WHtR related to CVD risk factors was 0.48 for men and 0.49 for women. The WHtR should therefore be considered as a screening tool.
Keywords: Obesity; Body Fat; Body Mass Index; Waist Circumference; Waist-to-Height Ratio; Cardiovascular Disease Risk Factors
References
  1. World Health Organization. Obesity : preventing and managing the global epidemic: report of a WHO Consultation. Geneva: World Health Organization;2000.
  2. Kannel WB, D’Agostino RB, Cobb JL. Effect of weight on cardiovascular disease. Am J Clin Nutr 1996; 63(Suppl): 419S-22S.
    Pubmed CrossRef
  3. Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, et al. Weight, weight change, and coronary heart disease in women. Risk within the ‘normal’ weight range. JAMA 1995; 273: 461-5.
    Pubmed CrossRef
  4. Metropolitan Life Insurance Company. The 1979 build study. Chicago: Society of actuaries and association of Life Insurance Medical Directors of America; 1980.
  5. Joseph L, Wasir JS, Misra A, Vikram NK, Goel K, Pandey RM, et al. Appropriate values of adiposity and lean body mass indices to detect cardiovascular risk factors in Asian Indians. Diabetes Technol Ther 2011; 13: 899-906.
    Pubmed CrossRef
  6. Pi-Sunyer FX. Obesity: criteria and classification. Proc Nutr Soc 2000; 59:505-9.
    Pubmed CrossRef
  7. Prentice AM, Jebb SA. Beyond body mass index. Obes Rev 2001; 2: 141-7.
    CrossRef
  8. Hyun YJ, Kim OY, Jang Y, Ha JW, Chae JS, Kim JY, et al. Evaluation of metabolic syndrome risk in Korean premenopausal women: not waist circumference but visceral fat. Circ J 2008; 72: 1308-15.
    Pubmed CrossRef
  9. Li R, Lu W, Jia J, Zhang S, Shi L, Li Y, et al. Relationships between indices of obesity and its cardiovascular comorbidities in a Chinese population. Circ J 2008; 72: 973-8.
    Pubmed CrossRef
  10. Lee JS, Aoki K, Kawakubo K, Gunji A. A study on indices of body fat distribution for screening for obesity. J Occup Health 1995; 37: 9-18.
    CrossRef
  11. Hsieh SD, Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in men-waist/height ratio as a simple and useful predictor. Int J Obes Relat Metab Disord 1995; 19: 585-9.
    Pubmed
  12. Ashwell M, Lejeune S, McPherson K. Ratio of waist circumference to height may be better indicator of need for weight management. BMJ 1996; 312:377.
    Pubmed KoreaMed CrossRef
  13. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors:systematic review and meta-analysis. Obes Rev 2012; 13: 275-86.
    Pubmed CrossRef
  14. Gil JH, Lee MN, Lee HA, Park H, Seo JW. Usefulness of the waist circumferenceto-height ratio in screening for obesity in Korean children and adolescents. Korean J Pediatr Gastroenterol Nutr 2010; 13: 180-92.
    CrossRef
  15. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000; 45: 23-41.
    CrossRef
  16. Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes:0·5 could be a suitable global boundary value. Nutr Res Rev 2010; 23:247-69.
    Pubmed CrossRef


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