Optimal cut-off of obesity indices to predict cardiovascular disease risk factors and metabolic syndrome among adults in Northeast China

Background CVD risk factors (hypertension, dyslipidemia and diabetes) and MetS are closely related to obesity. The selection of an optimal cut-off for various obesity indices is particularly important to predict CVD risk factors and MetS. Methods Sixteen thousand seven hundred sixty-six participants aged 18–79 were recruited in Jilin Province in 2012. Five obesity indices, including BMI, WC, WHR, WHtR and BAI were investigated. ROC analyses were used to evaluate the predictive ability and determine the optimal cut-off values of the obesity indices for CVD risk factors and MetS. Results BMI had the highest adjusted ORs, and the adjusted ORs for hypertension, dyslipidemia, diabetes and MetS were 1.19 (95 % CI, 1.17 to 1.20), 1.20 (95 % CI, 1.19 to 1.22), 1.12 (95 % CI, 1.10 to 1.13), and 1.40 (95 % CI, 1.38 to 1.41), respectively. However, BMI did not always have the largest adjusted AUROC. In general, the young age group (18 ~ 44) had higher ORs and AUROCs for CVD risk factors and MetS than those of the other age groups. In addition, the optimal cut-off values for WC and WHR in males were relatively higher than those in females, whereas the BAI in males was comparatively lower than that in females. Conclusions The appropriate obesity index, with the corresponding optimal cut-off values, should be selected in different research studies and populations. Generally, the obesity indices and their optimal cut-off values are: BMI (24 kg/m 2 ), WC (male: 85 cm; female: 80 cm), WHR (male: 0.88; female: 0.85), WHtR (0.50), and BAI (male: 25 cm; female: 30 cm). Moreover, WC is superior to other obesity indices in predicting CVD risk factors and MetS in males, whereas, WHtR is superior to other obesity indices in predicting CVD risk factors and MetS in females.