Background: The concept of being metabolically obese but normal weight (MONW) has emerged as a significant public health concern. Individuals with MONW exhibit insulin resistance and are at elevated risk for chronic diseases, despite having a body mass index (BMI) <25 kg/m2. Given the high prevalence of MONW among older Asian adults and the role of abdominal visceral fat in metabolic abnormalities in individuals with MONW, identifying an accurate waist circumference (WC)-based body adiposity index for older Asian adults is essential. Thus, this study aimed to determine the most accurate WC-based body adiposity index for identifying MONW in older Korean adults that are not underweight or obese.Methods: This cross-sectional study included 7,846 participants (3,536 males and 4,310 females) aged ≥60 years with a BMI of 18.5–24.9 kg/m2 from the Korea National Health and Nutrition Examination Survey. MONW was defined using metabolic syndrome criteria and sex-specific triglyceride–glucose Index cutoff points. Associations were analyzed using logistic regression, and discriminative ability was assessed using receiver operating characteristic curves. The analysis included BMI, WC and various WC-based adiposity indices, including the visceral adiposity index (VAI), body roundness index, waist-to-height ratio, conicity index, weight-adjusted waist index, and a body shape index.Results: While all WC-based indices were associated with MONW, only the VAI showed a stronger association (odds ratios ORs, 26.542 in males and 21.495 in females) and superior discriminative ability (area under the curves AUCs, 0.826 in males and 0.802 in females) in both sexes compared with WC (ORs, 4.538 and 4.060; AUCs, 0.679 and 0.676). Other indices showed weaker associations and lower areas under the curves than did the VAI and WC, regardless of sex.Conclusions: The VAI may serve as the most effective indicator for identifying MONW among older Korean adults that are not underweight or obese.
Bokun Kim (Tue,) studied this question.