Comparison of Health Risks according to the Obesity Types Based Upon BMI and Waist Circumference in Korean Adults: The 1998-2005 Korean National Health and Nutrition Examination Surveys

This study was performed to examine the health risks according to the obesity types based upon body mass index (BMI) and waist circumference (WC) cutoffs. The subjects were 8,966 adults aged 40-79 years from the 1998, 2001 and 2005 Korean National Health and Nutrition Examination Surveys. The subjects were classified into 4 types of obesity groups based on BMI and WC: BMIWC (BMI greater-than or equal to 25 kg/㎡ and WC greater-than or equal to 90 cm for males and greater-than or equal to 85 cm for females), WC (BMI less than 25 kg/㎡ and greater-than or equal to 90 cm for males and greater-than or equal to 85 cm for females), BMI (BMI greater-than or equal to 25 kg/㎡ and less than 90 cm for males and less than 85 cm for females), normal (BMI less than 25 kg/㎡ and less than 90 cm for males and less than 85 cm for females) groups. More than half (n = 5,103) of the subjects fell into the normal group and BMIWC group accounts for 58%, followed by BMI group of 27% and WC group of 16%. Mean ages of subjects were highest in WC group and lowest in BMI group. Blood levels of total cholesterol, triglyceride, LDL-cholesterol and glucose, and blood pressures were higher and HDL-cholesterol was lower in 3 types of obesity groups (BMIWC, WC, BMI) than in the normal group. Among the 3 obesity groups, energy and fat intake was significantly higher in BMIWC than in normal group in males, however, no differences were found among the 4 groups in females. The three obesity groups had greater odds ratios for hypertension, diabetes mellitus, hypercholesterolemia, hyper-LDL-cholesterolemia, hypo-HDL-cholesterolemia, hypertriglyceridemia, and metabolic syndrome compared to the normal group. Among 3 obesity groups, BMIWC group had the highest odds ratios for hypertension, diabetes mellitus, and metabolic syndrome. Especially BMIWC and WC groups showed the highest odds ratios for diabetes mellitus and metabolic syndrome, suggesting the potential role of abdominal obesity in diabetes mellitus and metabolic syndrome. Our data indicate that different types of obesity may show different degrees of health risks. The appropriate selection and use of obesity indexes may be effective for management of obesity as well as obesityrelated diseases.