Association between body fat percentage and metabolic and hematologic biomarkers in Korean adults

Recent interest in metabolically healthy obesity highlights the need to evaluate the relationship between adiposity and hematologic and metabolic biomarkers. With the increasing use of bioelectrical impedance analysis (BIA), measuring body composition, including percent body fat (PBF), has become more accessible. This study aimed to investigate the associations between PBF and hematologic and metabolic biomarkers related to cardiometabolic health. We conducted a retrospective, cross-sectional analysis using data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES-IX), which included BIA-based body composition metrics. A total of 5,518 adults with complete records and no predefined outliers were analyzed. Survey-weighted Pearson correlation coefficients were calculated by sex and age groups, followed by multiple linear regression adjusting for sex, age, and body weight. PBF was significantly associated with alanine transaminase (β = 1.06 per % PBF), hemoglobin (β = 0.02), hematocrit (β = 0.06), total cholesterol (β = 0.48), high-density lipoprotein cholesterol (β = -0.50), low-density lipoprotein cholesterol (β = 0.62), and triglyceride (β = 2.93). No significant association was found between PBF and aspartate transaminase. Notably, the associations of PBF with alanine transaminase and triglycerides varied by sex and age group. These findings suggest that PBF may be a useful non-invasive marker for assessing cardiometabolic risk, warranting further investigation in diverse populations.