title: Diagnostic performance of body mass index using the Western Pacific Regional Office of World Health Organization reference standards for body fat percentage.
abstract: Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic performance of BMI using the Western Pacific Regional Office of World Health Organization reference standard for BF%-defined obesity by sex and age and identified the optimal BMI cut-off for BF%-defined obesity using receiver operating characteristic curve analysis. BMI-defined obesity (≥25 kg/m(2)) was observed in 38.7% of men and 28.1% of women, with a high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72% women) for BF%-defined obesity (25.2%, men; 31.1%, women). The optimal BMI cut-off (24.2 kg/m(2)) had 78% sensitivity and 71% specificity. BMI demonstrated limited diagnostic accuracy for adiposity in Korea. There was a -1.3 kg/m(2) difference in optimal BMI cut-offs between Korea and America, smaller than the 5-unit difference between the Western Pacific Regional Office and global World Health Organization obesity criteria.
authors: Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors: Jong Lull
authors: 0000-0001-8931-0256
authors: JL
authors: Yoon
authors: Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors: Jung Jin
authors: 0000-0001-8871-8858
authors: JJ
authors: Cho
authors: Sejong Samsung Med Clinic, Kangbuk Samsung Hospital, Sejong, Korea.
authors: Kyung Mi
authors: 0000-0003-2021-6039
authors: KM
authors: Park
authors: Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors: Hye Mi
authors: 0000-0003-2112-1613
authors: HM
authors: Noh
authors: Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors: Yong Soon
authors: 0000-0002-8926-9836
authors: YS
authors: Park
mesh_terms: D000273:Adipose Tissue / Q000502:physiology*; D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000175:diagnosis*; D012372:ROC Curve; D012015:Reference Standards; D056910:Republic of Korea; D055815:Young Adult
keywords: Adiposity; Body Composition; Body Mass Index; Obesity
references: Obes Res. 2002 Dec;10 Suppl 2:97S-104S
references: 12490658
references: Lancet. 2004 Jan 10;363(9403):157-63
references: 14726171
references: World Health Organ Tech Rep Ser. 1995;854:1-452
references: 8594834
references: Int J Obes Relat Metab Disord. 1998 Dec;22(12):1164-71
references: 9877251
references: Adapt Phys Activ Q. 2013 Oct;30(4):373-86
references: 24197625
references: N Engl J Med. 2006 Aug 24;355(8):779-87
references: 16926276
references: Int J Obes (Lond). 2008 Jun;32(6):959-66
references: 18283284
references: Obesity (Silver Spring). 2009 Jun;17(6):1281-6
references: 19584885
references: N Engl J Med. 2011 Feb 24;364(8):719-29
references: 21345101
references: Am J Clin Nutr. 2005 May;81(5):1018-25
references: 15883424