Journal of Obesity & Metabolic Syndrome



Korean J Obes 2014; 23(2): 93-98

Published online June 30, 2014

Copyright © Korean Society for the Study of Obesity.

Relationship between Body Fat Percent and Obesity Indices in Short Stature Women

Ji-Hoon Myung, Young-Ah Han, Kyung-Bin Min, Jun-Young Kwon, Yong-Kyun Roh, Min-Kyu Choi*

Department of Family Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea

Received: November 15, 2013; Reviewed : December 2, 2013; Accepted: January 16, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Body mass index (BMI) is frequently used as an index to assess obesity. However, BMI has limitations in accurately predicting body fat mass in terms of stature intervals. Therefore, we analyzed the relationship between body fat % and three obesity indices; BMI, waist circumference (WC) and waist circumference to height ratio (WHtR) in short stature women.
Methods: Korean women (N=317) of 19-60 years of age with short stature, defined by 1-10th percentile stature, were enrolled as subjects. Correlation analysis was used to evaluate relationship of body fat % and the obesity indices. After defining obesity as body fat % over 30, area under curve (AUC), sensitivity and specificity of the indices were obtained by receiver operating characteristic (ROC) analysis. Additionally, optimal cutoff values of the indices and sensitivity, specificity at that time were obtained.
Results: There was statistically significant and positive correlation between body fat % and the indices (r=0.804 for BMI, 0.763 for WC, 0.768 for WHtR). All indices showed moderate diagnostic accuracy according to AUC (0.888 for BMI, 0.885 for WC, 0.889 for WHtR). Both sensitivity and specificity of WHtR was high (0.758, 0.885 respectively). Specificity of BMI and WC was higher than WHtR but, their sensitivity was lower than WHtR. The optimal cutoff values were 22.6 kg/m2 for BMI, 75.5 cm for WC, 0.50 for WHtR.
Conclusion: Among the obesity indices, we observed WHtR 0.5 to be superior to BMI 25 or WC 85 cm as an index to diagnose obesity in women of short stature.

Keywords: Obesity, Short stature, Body fat percent, Body mass index, Waist circumference, Waist circumference to height ratio

Fig. 1. Ratio of obesity according to BMI, WC, WHtR, BF% cutoff values. (A) shows the obesity ratio of the subjects according to currently used obesity index cutoff values (BMI≥25, WC≥85, WHtR≥0.5, BF%≥30). (B) shows the obesity ratio of the subjects according to newly obtained optimal cutoff values (BMI≥22.6, WC≥75.5). WHtR and BF% cutoff values are same.
Fig. 2. Receiver operating characteristic (ROC) curves of the three obesity indices. Bold line indicates BMI, dotted line WC, and black line WHtR, respectively.

General characteristics of the subjects

Correlation coefficient of BMI, WC, WHtR and BF

Area under curve (AUC) of three obesity indices to diagnose obesity defined by BF%≥30*

Sensitivity and specificity of three obesity indices to diagnose obesity defined by BF%≥30*

Optimal cutoff values, sensitivity and specificity of three obesity indices to diagnose obesity defined by BF%≥30*

  1. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894:1-253.
  2. Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey 2005 (KNHANES III). Seoul: Korea Centers for Disease Control and Prevention; 2007.
  3. Bergman RN, Stefanovski D, Buchanan TA, Sumner AE, Reynolds JC, Sebring NG, et al. A better index of body adiposity. Obesity (Silver Spring) 2011;19:1083-9.
    Pubmed KoreaMed CrossRef
  4. Prentice AM, Jebb SA. Beyond body mass index. Obes Rev 2001;2:141-7.
  5. Garn SM, Leonard WR, Hawthorne VM. Three limitations of the body mass index. Am J Clin Nutr 1986;44:996-7.
  6. Sorkin JD, Muller DC, Andres R. Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore Longitudinal Study of Aging. Am J Epidemiol 1999;150:969-77.
    Pubmed CrossRef
  7. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012;13:275-86.
    Pubmed CrossRef
  8. Gil JH, Lee MN, Lee HA, Park H, Seo JW. Usefulness of the waist circumference-to-height ratio in screening for obesity in Korean children and adolescents. Korean J Pediatr Gastroenterol Nutr 2010;13:180-92.
  9. Korean Agency for Technology and Standards. 6th Korea human scale survey report. 2010 [accessed 2011 Feb 23]; Available from:URL:
  10. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000;45:23-41.
  11. Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J 2005;47:458-72.
    Pubmed CrossRef
  12. L?pez-Alvarenga JC, Montesinos-Cabrera RA, Vel?zquez-Alva C, Gonz?lez-Barranco J. Short stature is related to high body fat composition despite body mass index in a Mexican population. Arch Med Res 2003;34:137-40.
  13. Kim MK, Han K, Kwon HS, Song KH, Yim HW, Lee WC, et al. Normal weight obesity in Korean adults. Clin Endocrinol (Oxf) 2014;80:214-20.
    Pubmed CrossRef