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

한국 성인에서 체질량지수와 허리둘레를 기준으로 분류한 비만 유형에 따른 특성 비교: 1998-2005 국민건강영양조사

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${\geq}$ 25 kg/$m^2$ and WC${\geq}$ 90 cm for males and ${\geq}$ 85 cm for females), WC (BMI < 25 kg/$m^2$ and ${\geq}$ 90 cm for males and ${\geq}$ 85 cm for females), BMI (BMI ${\geq}$ 25 kg/$m^2$ and < 90 cm for males and < 85 cm for females), normal (BMI < 25 kg/$m^2$ and < 90 cm for males and < 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.

본 연구 결과를 종합하여 볼 때 모든 비만 유형에서 고콜레스테롤혈증, 고LDL콜레스테롤혈증, 고중성지방혈증, 대사증후군의 위험도가 증가하였으나, 당뇨병에서는 복부비만의 유무에 따라 위험도에서 유의적인 차이가 있었다. 대사증후군에서는 복부비만을 가지고 있는 비만 유형에서 질병위험도의 값이 크게 나타나 복부비만은 대사증후군의 강력한 예측인자로 사용 될 수 있을 것으로 사료된다. 비만 유형에 따른 질병 위험도가 달라지는 것은 비만을 진단하는 지표 중 어느 기준을 사용하여 비만을 구분하느냐에 따라 위험도가 높아지는 질병이 다름을 의미하며, 비만과 관련된 질병의 관리에 있어 특정 질병과 관련된 적절한 비만 지표를 선택하여 사용하는 것이 비만 유형에 따른 비만인의 건강관리에 효과적일 것으로 사료된다.