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Background  Body mass index (BMI) has been used as an indirect predictor for the risk of metabolic syndrome. However, there are challenges in evaluating the risk of metabolic syndrome using BMI in certain parts of the world. Therefore, it is worth exploring additional factors that could supplement BMI to predict the risk of metabolic syndrome. In this study, we assessed the combined effect of BMI and perception for predicting metabolic syndrome.    Methods  We used the fifth Korea National Health and Nutrition Examination Surveys (KNHANES V, 2010–12, N = 16,537) in this study. Multivariable logistic regression analysis was performed to examine the association while controlling for potential confounding variables. We also performed an analysis for the combined effect of BMI and perception of body size, and subgroup analysis by age group or moderate physical activity.    Results  Data from 16,537 participants were analyzed in this study (males: 6,978, females: 9,559). Among them, metabolic syndrome was diagnosed in 1,252 (17.9 %) males and 2,445 (25.6 %) females, respectively. The combination of BMI and body size perception had a positive relation with the presence of metabolic syndrome. People who perceived themselves to be overweight for their body size had a higher risk for metabolic syndrome even if they have the same BMI.    Conclusion  Our findings suggest that the combination of body size perception and BMI is useful in predicting the risk of metabolic syndrome. The use of complementary predictors could reduce the risk for inaccurate prediction of metabolic syndrome.

bmc public health

Combined effect of body mass index and body size perception on metabolic syndrome in South Korea: results of the fifth Korea National Health and Nutrition Examination Surveys (2010-2012)