Journal of Obesity & Metabolic Syndrome

Korean Society for the Study of Obesity (대한비만학회)
권호 표지

Measuring BMI Cutoff Points of Korean Adults Using Morbidity of BMI-related Diseases

체질량지수와 유의한 상관성을 갖는 질환들의 이환율을 이용한 한국인의 체질량지수 변별점 측정: ROC 곡선을 이용하여

  • 박종헌 (서울대학교 의과대학 의료관리학연구소)
  • Published : 2011.03.30
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Abstract

Background: WHO Western Pacific Regional Office (WPRO) has proposed a redefined classification of weight according to body mass index (BMI) for Asian adults in 2000. The purpose of this study was to determine the optimal BMI cutoff points that correlate with the increased risk of obesity related disorders among the Korean population. The relationship between BMI and the morbidity attributed to BMI-related diseases was examined by sex and age. Methods: Korean National Health and Nutrition Examination Survey (KNAHNES) data from years 1998 to 2007 were used for this study. The data included physical examination reports, laboratory tests, and interviews of 23,671 adults. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff points between BMI and morbidity attributed to BMI-related diseases. Results: The AUCs (Area Under the Curve) were highest when the optimal cutoff points of BMI were estimated using the morbidity of hypertension, DM or hypercholesterolemia. Using the morbidity of positively related diseases in both men and women, the optimal cutoff points of BMI in Korean adults were estimated to be 23.0-24.5 $kg/m^2$ levels. The differences according to sex and age were not significant. Conclusion: The optimal cutoff points of BMI in Korean adults estimated from this study were similar to the overweight criteria of WHO WPRO re-classification. This study provides evidence to support the re-classification of BMI in Korean population.

연구배경: 2000년 세계보건기구 서태평양지역회의는 인종적 차이를 고려한 아시아인들의 체질량지수 기준을 재정의하여 발표하였고, 대한비만학회도 이 재정의 기준을 바로 수용하여 한국에 적용하기 시작하였다. 이에 따라 본 연구는 한국인의 체질량지수와 관련 질환 이환율 사이 상관성을 성 연령별로 파악하고, 질환 이환의 위험도가 현저하게 증가하는 시점의 체질량지수 변별점을 추정하기 위한 목적으로 수행되었다. 방법: 1998년 11-12월(제1기), 2001년 11-12월(제2기), 2005년 4-6월(제3기), 2007년 7-12월(제4-1기)에 수행된 국민건강영양조사의 검진자료 및 설문조사 자료(총 23,671명)를 사용하였다. 교육수준, 흡연을 통제하여 체질량지수와 고혈압, 당뇨병, 고콜레스테롤혈증, 골관절염, 천식 등 질환군 사이의 성 연령에 따른 편상관계수를 구하였고, 이들 중 유의한 질환 이환율을 대상으로 ROC 곡선 분석을 이용하여 체질량지수의 변별점을 구하였다. 결과: 단일 질환 이환율을 기준으로 분석했을 때보다 고혈압, 당뇨병, 고콜레스테롤혈증 중 한 가지 이상의 질환에 이환된 경우를 기준으로 최적 변별점을 추정했을 때 AUC 값이 가장 높았다. 또한 체질량지수와 유의한 양의 상관성을 갖는 질환 이환율을 기준으로 추정된 한국 성인의 체질량지수 최적 변별점은 23.0-24.5 $kg/m^2$ 사이에서 추정되었고, 성 연령구간별 차이는 뚜렷하지 않았다. 결론: 본 연구에서 추정된 한국인의 체질량지수 최적 변별점은 세계보건기구 서태평양지역회의에서 재정의했던 과체중 기준과 유사한 값이다. 이 결과는 체질량지수 기준 재정의가 한국 성인에게도 유효하게 적용될 수 있을 것이라는 점을 지지하고 있다.

Keywords

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