Utility of obesity indicators for metabolically healthy obesity: an observational study using the Korean National Health and Nutrition Examination Survey (2009-2010).

backgroundObese individuals who are not at an elevated risk for cardiovascular disease are described as having metabolically healthy obesity (MHO). We sought to identify clinically useful indicators of MHO.

methodsRecords of the Korean National Health and Nutrition Examination Survey (2009-2010) were used to analyze 3,770 obese subjects (body mass index ≥ 25 kg/m2), who were divided into metabolic syndrome and MHO groups. Persons who met less than 3 of the criteria of metabolic syndrome (MS) were defined as having MHO. We estimated age-specific prevalence rates according to the number of MS criteria that were satisfied (patients meeting 0, ≤1, and ≤2 criteria of MS). Receiver operating characteristic analysis was performed to identify the best indicators of MHO.

resultsThe prevalence of MHO among obese patients decreased with age. When MHO was defined by the fulfillment of ≤2 criteria of MS, the areas under the curves (AUC) for waist circumference and waist-to-height ratio were 0.743 and 0.747 in men and 0.712 and 0.741 in women, respectively. Waist circumference and waist-to-height ratio were the most accurate predictors of MHO for all investigated definitions.

conclusionsWaist circumference and waist-to-height ratio provide useful indicators for diagnosing MHO, and are more accurate than body mass index, fat percentage, or weight-adjusted appendicular skeletal muscle mass in the Korean population.