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방창석 ( Chang Seok Bang ),오정환 ( Jung Hwan Oh ) 대한내과학회 2019 대한내과학회지 Vol.94 No.5
Obesity is associated with various comorbidities, such as type II diabetes, hypertension, dyslipidemia, and cardiovascular disease. Gastrointestinal complications are also frequent and obesity is a direct cause of nonalcoholic fatty liver disease, and are risk factors for gastroesophageal reflux disease, pancreatitis, gallstone disease, diarrhea, dyssynergic defection, and various gastrointestinal cancers. Diagnosis is usually made by measuring body mass index (BMI). Although BMI is correlated with body fat mass, it may overestimate subjects with high muscle mass and underestimate subjects with low muscle mass. Co-measurement of waist circumference as a reflection of abdominal obesity for subjects with BMIs ranging from 25 to 35 kg/㎡ has been recommended; however, it is still an anthropometric diagnosis that does not clearly discriminate subjects at risk for developing comorbidities. Biomarkers reflect the underlying biological mechanisms of obesity and can be used to characterize the obesity phenotype (i.e., at high risk for disease development) as well as a target for disease-causing factors. In this article, we describe the conventional diagnosis, biomarkers of obesity, and current challenges. (Korean J Med 2019;94:414-424)