Background: Body mass index (BMI) and waist
circumference have been widely used as indices to
determine obesity along with waist /height ratio. The
purpose of this study was to compare the efficacy of
obesity indices which correlate with the metabolic risk
factors in adults in Jeju island.
Methods: BMI, waist circumference, and waist/height
ratio were measured as indices for obesity. Four items
(high blood pressure, high fasting glucose, high
triglyceride, and low HDL cholesterol) were included as
metabolic risk factors. Metabolic high risk group was
defined as the sum of the metabolic risk factor score of ≥
3 (one point per item, if present). Each obesity index was
compared to metabolic risk factors.
Results: All obesity indices showed significant
correlation with metabolic risk factors.
In men, waist circumference had the largest area under
the curve (AUC)s for the identification of high risk group
(0.729, P < 0.001). However, In women, waist/height ratio
had the largest AUCs (0.803 , P < 0.001). People with
more than 3 metabolic risk factors with normal waist
circumference were also analyzed. In both men and
women, Waist/height ratio had the largest AUCs (men
0.706, P = 0.005, women 0.785, P = 0.010).
Conclusion: Waist/height ratio was the most significant
index for screening metabolic high risk group in women.
In normal waist group, waist/height ratio in both men and
women respectively served as effective index for screening
metabolic high risk group.

Keywords: Body mass index, Waist circumference,Waist/Height ratio, Metabolic risk factor