• Xin Liu, Yaling Zhao, Qiang Li, Shaonong Dang, and Hong Yan.
• Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, People's Republic of China.
• Am. J. Hum. Biol. 2017 Jul 8; 29 (4).

ObjectivesObesity classification using body mass index (BMI) may miss subjects with elevated body fat percentage (BF%) and related metabolic risk factors. We aimed to evaluate whether BF% calculated by equations could provide more information about metabolic risks, in addition to BMI classification, in a cross-sectional rural Chinese population.MethodsA total of 2,990 men and women aged 18-80 years were included in this study. BF% was calculated using previously validated Chinese-specific equations. Metabolic syndrome was defined according to the updated National Cholesterol Education Program Panel III criteria for Asian Americans.ResultsIn total, 33.6% men and 32.9% women were overweight/obese according to BMI classification. Among those within the normal BMI range, 25.4% men and 54.7% women were indicated as overweight or obese given their elevated BF% (men: BF% ≥ 20%; women: BF% ≥ 30%). In both men and women, compared with those with normal BMI and BF% (NBB), subjects with normal BMI but elevated BF% (NBOB) were more likely to carry abnormal serum lipid profile and to have higher risks of metabolic syndrome. The multivariable adjusted odds ratios (95% confidence intervals) for metabolic syndrome were 5.45 (2.37-9.53, P < 0.001) and 5.65 (3.36-9.52, P < 0.001) for men and women, respectively. Moreover, the women with NBOB also showed higher blood pressure and serum uric acid than women with NBB.ConclusionsOur study suggested that high BF% based on equations may indicate adverse metabolic profiles among rural Chinese adults with a normal BMI.© 2017 Wiley Periodicals, Inc.

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