Comparing validity of Body Mass Index, Waist to Hip Ratio, and Waist Circumference to Cardiovascular Disease Risk Factors in Korean Elderly

Moon, Hyun Kyung; Kim, Eu Gene

Abstract

The purpose of this study was 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 in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n = 1017). Anthropometric indices and cardiovascular risk factors were measured, and 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. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p < 0.05). Among life style factors the current smokers were prevalent in obese male (p < 0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p < 0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p < 0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p < 0.05). Among 7 cardiovascular risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC > WHR > BMI in male and BMI > WHR > WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also cardiovascular risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of cardiovascular risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.