"A Body Shape Index" in middle-age and older Indonesian population: scaling exponents and association with incident hypertension

Association between anthropometric indices and hypertension: identifying optimal cutoff points for U.S. adults across different populations

Objective

This study compares the relationships between five anthropometric indices, a body shape index (ABSI), body roundness index (BRI), waist circumference (WC), body mass index (BMI) and waist-to-height ratio (WHtR), and hypertension, assessing their predictive capacities. The aim is to determine the specific numerical changes in hypertension incidence, systolic blood pressure (SBP) and diastolic blood pressure (DBP) for each increase in standard deviation of these indices, and to identify the optimal predictive indicators for different populations, including the calculation of cutoff values.

Methods

This study used data from the NHANES datasets spanning 2007 to 2018. Logistic regression analysis was used to quantify the associations between these anthropometric indices and hypertension, calculating β coefficients and odds ratios (ORs). Receiver operating characteristic (ROC) analysis was used to evaluate the predictive ability of each index for hypertension.

Results

For each increase in standard deviation in WC, BMI, WHtR, ABSI and BRI, the prevalence of hypertension increased by 33% (95% CI: 27%-40%), 32% (95% CI: 26%-38%), 35% (95% CI: 28%-42%), 9% (95% CI: 4%-16%) and 32% (95% CI: 26%-38%), respectively. The SBP correspondingly increased by 2.36 mmHg (95% CI: 2.16-2.56), 2.41 mmHg (95% CI: 2.21-2.60), 2.48 mmHg (95% CI: 2.28-2.68), 0.42 mmHg (95% CI: 0.19-0.66) and 2.46 mmHg (95% CI: 2.26-2.66), respectively. Similarly, DBP increased by 1.83 mmHg (95% CI: 1.68-1.98), 1.72 mmHg (95% CI: 1.58-1.87), 1.72 mmHg (95% CI: 1.57-1.88), 0.44 mmHg (95% CI: 0.27-0.62) and 1.64 mmHg (95% CI: 1.48-1.79). In the youth and middle-aged groups, WC had the best predictive ability, with AUCs of 0.749 and 0.603, respectively. Among the elderly group, the AUCs for all five indices ranged between 0.5 and 0.52.

Conclusion

Increases in WC, BMI, WHtR and BRI are significantly associated with higher incidences of hypertension and increases in SBP and DBP, while the impact of ABSI on blood pressure is relatively weak. Stratified analysis indicates significant age-related differences in the predictive value of these indices, with the strongest associations observed in the youth group, followed by the middle age group, and the weakest in the elderly. WC demonstrates excellent predictive ability across youth populations.

Dose-response association of obesity and risk of mental health among tehranian residents: result of a cross-sectional study

BACKGROUND

Obesity and mental health issues are two of the most prevalent global public health issues for a significant portion of people. The purpose of this study was to investigate the relationship between obesity indicators and mental health in Tehran-dwelling Iranian adults.

METHODS

We conducted a cross-sectional study on healthy Iranian adults using a convenience sampling technique. The short form of the Depression Anxiety and Stress Scale (DASS-21) was used to measure the outcome, and independent variables included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), and a body shape index (ABSI). The relationship between obesity and mental health was investigated using a multivariate logistic regression model. The non-linear dose-response relationships were evaluated using restricted cubic splines (RCS) with three knots. The Benjamini-Hochberg procedure was used to adjust for multiple testing.

RESULTS

In our study of 434 participants, females made up 52% of the participants, with a mean age of 38.57 years. In all, 54.6%, 53.9%, and 56.6% were classified as having anxiety, depression, and stress respectively. Logistic regression analysis showed that the odds of mental health components including anxiety, depression, or stress was not significantly different across the tertiles of the obesity indicators. We observed a significant dose-response relationship between BAI and ABSI and the risk of anxiety (PBenjamini-Hochberg 0.028 > Pdose-response 0.023) and stress (PBenjamini-Hochberg 0.028 > Pdose-response 0.003) but not depression (PBenjamini-Hochberg 0.014 < Pdose-response 0.018). The lowest risk for anxiety was observed in people with a BAI of 28% and ABSI equal to 0.079. The risk of stress seemed to increase beyond an ABSI of 0.086.

CONCLUSION

Our findings showed no direct linear association between obesity indices and anxiety. However, a dose-response relationship was observed between BAI and ABSI and the risk of anxiety and stress, indicating the need for further investigation.

Association between anthropometric indices and 5-year hypertension incidence in the general Japanese population

No existing reports demonstrate the association between anthropometric indices (body mass index, waist circumference, body roundness index, a body shape index) and hypertension according to sex and age in the general Japanese population. This retrospective analysis involved individuals aged 30-69 years who underwent annual medical checkups at Kagoshima Koseiren Hospital in 2005-2019, and who did not meet hypertension criteria at baseline. The outcome was hypertension incidence after 5 years, and its association with baseline anthropometric indices was evaluated using multivariable logistic regression analysis by sex and age. In 41,902 participants (age 52.3 ± 10.2 years, 47.7% men), 7622 individuals (18.2%) developed hypertension after 5 years. Body mass index, waist circumference, and body roundness index were significantly associated with the development of hypertension in both men and women across all age categories from 30 s to 60 s. In the population with a body mass index <25 kg/m2, waist circumference and body roundness index were significantly associated with hypertension after 5 years. A body shape index was significantly associated with the development of hypertension in men in their 40 s and 50 s but not in women of any age group. The area under the curve values were lower for a body shape index than for body mass index, waist circumference, and body roundness index in both men and women of all age groups. A body shape index was not a stronger indicator for 5-year hypertension incidence than body mass index, waist circumference, or body roundness index in both men and women across age groups from their 30s-60 s. The results of this study will help to more efficiently identify populations at high risk of developing hypertension and provide preventive interventions. A total of 41,902 participants from health checkup programs were stratified by gender and age to investigate the association between baseline anthropometric indices and hypertension incidence over a 5-year period. BMI, WC, and BRI were almost equally effective and showed a better association with risk of developing hypertension in women and young adults compared to men and old adults. Conversely, ABSI showed no greater association than BMI or WC in any age group in both men and women. ABSI, a body shape index; AUC, area under the curve from receiver operating characteristic curve analysis; BMI, body mass index; BRI, body roundness index; WC, waist circumference.

Association between visceral fat mass and arterial stiffness among community-based screening participants

Obesity and arterial stiffness are important risk factors for disease development. However, the relationship between obesity and arterial stiffness remains unclear. We examined the relationship of visceral fat area (VFA) and anthropometric obesity indices with arterial stiffness. This cross-sectional study was conducted among 2 789 participants (50% women) who underwent both VFA and brachial-ankle pulse wave velocity (baPWV) measurements during health checkups. Body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI) were assessed. Visceral fat area was quantified using abdominal computed tomography. In women, VFA and all anthropometric indices positively correlated with age. In men, VFA, WHtR, ABSI, and BRI positively correlated with age; BMI inversely correlated with age; and WC did not correlate with age. Visceral fat area significantly correlated with anthropometric indices, but its correlation with ABSI was modest. In women, baPWV showed modest correlations with VFA and anthropometric indices and little correlations with BMI. In men, baPWV modestly correlated with VFA, WHtR, ABSI, and BRI, but inversely correlated with BMI and did not significantly correlate with WC. The multivariable-adjusted model showed that VFA and anthropometric indices, except ABSI, were inversely associated with baPWV; however, they were positively associated with metabolic syndrome components, including hypertension, dyslipidemia, and hyperglycemia. A body-shaped index weakly associated positively with baPWV, but misclassified individuals at risk for metabolic syndrome components. Visceral fat area and most anthropometric obesity indices were positively associated with hypertension, dyslipidemia, and hyperglycemia, but inversely associated with baPWV. Visceral fat area and anthropometric indices, except a body-shaped index, were inversely associated with brachial-ankle pulse wave velocity but positively associated with metabolic syndrome components, including hypertension, dyslipidemia, and hyperglycemia.

Predicting hypertension by obesity- and lipid-related indices in mid-aged and elderly Chinese: a nationwide cohort study from the China Health and Retirement Longitudinal Study

BACKGROUND

Currently, the study outcomes of anthropometric markers to predict the risk of hypertension are still inconsistent due to the effect of racial disparities. This study aims to investigate the most effective predictors for screening and prediction of hypertension (HTN) in the Chinese middle-aged and more elderly adult population and to predict hypertension using obesity and lipid-related markers in Chinese middle-aged and older people.

METHODS

The data for the cohort study came from the China Health and Retirement Longitudinal Study (CHARLS), including 4423 middle-aged and elderly people aged 45 years or above. We examined 13 obesity- and lipid-related indices, including waist circumference (WC), body mass index (BMI), waist-height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product index (LAP), conicity index (CI), Chinese visceral adiposity index (CVAI), triglyceride-glucose index (TyG-index) and their combined indices (TyG-BMI, TyG-WC, TyG-WHtR). To compare the capacity of each measure to forecast the probability of developing HTN, the receiver operating characteristic curve (ROC) was used to determine the usefulness of anthropometric indices for screening for HTN in the elderly and determining their cut-off value, sensitivity, specificity, and area under the curve (AUC). Association analysis of 13 obesity-related anthropometric indicators with HTN was performed using binary logistic regression analysis.

RESULTS

During the four years, the incident rates of HTN in middle-aged and elderly men and women in China were 22.08% and 17.82%, respectively. All the above 13 indicators show a modest predictive power (AUC > 0.5), which is significant for predicting HTN in adults (middle-aged and elderly people) in China (P < 0.05). In addition, when WHtR = 0.501 (with an AUC of 0.593, and sensitivity and specificity of 63.60% and 52.60% respectively) or TYg-WHtR = 4.335 (with an AUC of 0.601, and sensitivity and specificity of 58.20% and 59.30% respectively), the effect of predicting the incidence risk of men is the best. And when WHtR = 0.548 (with an AUC of 0.609, and sensitivity and specificity of 59.50% and 56.50% respectively) or TYg-WHtR = 4.781(with an AUC of 0.617, and sensitivity and specificity of 58.10% and 60.80% respectively), the effect of predicting the incidence risk of women is the best.

CONCLUSIONS

The 13 obesity- and lipid-related indices in this study have modest significance for predicting HTN in Chinese middle-aged and elderly patients. WHtR and Tyg-WHtR are the most cost-effective indicators with moderate predictive value of the development of HTN.

Obesity-and lipid-related indices as a predictor of hypertension in Mid-aged and Elderly Chinese: A Cross-sectional Study

Objective

Middle-aged and elderly people in China probably suffer from hypertension. There is a close relationship between obesity-and lipid-related index and hypertension, which is recognized by recent studies. However, these studies have not systematically compared the relationship between the two. We aim to find the most effective obesity-and lipid-related index for predicting hypertension.

Method

A total of 9488 middle-aged and elderly people in China participated in this study. In this study, the subjects were divided into male and female groups by the definition of the 2018 Chinese Guidelines for Prevention and Treatment of Hypertension. Searching for the best predictors among 13 obesity-and lipid-related indicators through binary logistic regression analyses and receiver operator curve (ROC). These 13 indicators are body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR).

Results

After adjusting bias, all 13 indexes are risk factors for hypertension. In ROC curve analysis, thirteen obesity-and lipid-related factors can predict the occurrence of hypertension. Among them, CVAI has the best prediction effect (male: AUC = 0.660, female: AUC = 0.699). AUC for WHtR was equal to that for BRI and TyG - WHtR in identifying hypertension in male. Similarly, AUC of TyG-BMI and BMI were the same. In females, AUC for WHtR and BRI were the same when predicting hypertension. AUC of ABSI was much lower than other test indexes.

Conclusion

In predicting hypertension, thirteen obesity-and lipid-related factors are effective. In addition, in males and females, CVAI is the best indicator to indicate hypertension. TyG-WHtR, WHtR, and BRI performed well in predicting metabolic syndrome in both males and females. ABSI has a poor ability to predict hypertension.

Evaluation of Arterial Stiffness and Its Relation to Innovative Anthropometric Indices in Persian Adults

Background

BMI has been evaluated as an old criterion to evaluate obesity in individuals, but it does not assess abdominal obesity and lean mass. We aimed to evaluate the possible relationship of new anthropometric indices (namely, a body shape index (ABSI), the body roundness index (BRI), the visceral adiposity index (VAI), the visceral fat area (VFA), and waist-hip ratio (WHR)), with one of the known critical factors of atherosclerosis, arterial stiffness.

Methods

Overall 5921 individuals were enrolled and were divided into four groups according to BMI. Novel anthropometric parameters including, ABSI, BRI, VAI, VFA, and WHR were calculated. The carotid-femoral pulse wave velocity (cf-PWV) was used to evaluate arterial stiffness. Multiple regression analysis was performed to assess the relationship between cf-PWV and innovative Anthropometric indices.

Results

This study population consisted of 3109 women and 2812 males. In men with overweight, cf-PWV was significantly related to BMI, ABSI, BRI, WC, VAI, VFA, and WHR. However, among men with obesity, cf-PWV was associated with BRI, VAI, and VFA. Among women with overweight, cf-PWV was also related to all mentioned indices except ABSI; although, cf-PWV was only associated with VFA and WHR in women with obesity.

Conclusion

Our results showed that VFA in women and VAI in men are strongly related to arterial stiffness and can be used to identify predictors of vascular disease or organic vascular dysfunction.

Effectiveness of a body shape index in predicting pediatric high blood pressure

BACKGROUND

A body shape index (ABSI) is an emerging anthropometric indicator, challenging two traditional parameters: body mass index (BMI) and waist circumference (WC). We aimed to systematically compare and validate the capability of anthropometric indicators for determining pediatric high blood pressure (HBP).

METHODS

A total of 3150 participants aged 7-17 years were enrolled from Suzhou, China. Areas under the receiver operating characteristic curve (AUC) were obtained to evaluate the performance of anthropometric indicators in detecting HBP. DeLong's test was used to examine whether the AUCs of anthropometric indicators in contrast to BMI or original ABSI were statistically different. Furthermore, a meta-analysis was performed to combine results from this study and five similar articles from databases.

RESULTS

In Suzhou population, BMI exhibited the largest AUC (AUC = 0.705), followed by WC (AUC = 0.669) and original ABSI (AUC = 0.514). Modified ABSI (AUC: 0.537-0.681), although had slightly better performance than original ABSI, was still less valuable than BMI (P &lt; 0.05), either in the total sample or in boys. The meta-analysis with 21108 children and adolescents subsequently confirms the results derived from Suzhou population.

CONCLUSIONS

In predicting pediatric HBP, original ABSI and modified ABSI underperform BMI and WC.

IMPACT

The current study is the first to evaluate whether original ABSI or modified ABSI is comparable to BMI and WC for screening HBP in children and adolescents. In predicting pediatric HBP, original ABSI and modified ABSI do not perform as well as traditional anthropometric indicators, such as BMI and WC. BMI remains the optimal indicator in pediatric HBP screening. This study provides a theoretical basis for the early identification of HBP in children and adolescents by adopting effective predictors.

Identification of the Best Anthropometric Index for Predicting the 10-Year Cardiovascular Disease in Southwest China: A Large Single-Center, Cross-Sectional Study

INTRODUCTION

This population-based cross-sectional study aimed to identify the best predictor of the 10-year cardiovascular (CV) high risk among old and new anthropometric indices.

METHODS

We investigated 76,915 adults older than 18 years of age living in southwest China. Ten obesity indices were calculated. The 10-year cardiovascular disease (CVD) risk was estimated using the Framingham risk score. Receiver operating characteristic curve analysis was performed to assess the ability of the anthropometric index to predict the 10-year high risk of CVD events.

RESULTS

The waist-to-hip ratio (WHR) had the highest area under the curve (AUC) value (0.711; sensitivity: 62.22%, specificity: 42.73%) in men, while the body fat index (BAI) had the lowest AUC value (0.624, sensitivity: 49.07%, specificity: 54.84%). The waist-to-height ratio (WHtR) and the body roundness index (BRI) showed the highest AUC value (0.751, sensitivity: 39.24%, 39.83%, specificity: 75.68%, 68.59%) in women, while the BAI showed the lowest AUC value (0.671, sensitivity: 53.15%, specificity: 57.14%).

CONCLUSIONS

The WHR was the best anthropometric measure for assessing the 10-year high risk of CVD in men, while the WHtR and BRI were the best measures for women. In men, the WHR should be < 0.88, and in women, the WHtR should be < 0.502 or the BRI should be < 3.41.

Utility of a Body Shape Index Parameter in Predicting Cardiovascular Disease Risks

Background: Anthropometric indices are used as predictors of cardiovascular disease (CVD). The most used indices are body mass index (BMI) and waist circumference (WC); however, there are limitations regarding their validity to address different body shapes, fat and lean mass distribution. A body shape index (ABSI) has been proposed as an alternative parameter to reflect differences in body shape and potentially be more useful for predicting CVD. ABSI is calculated by ABSI = WC / (BMI^2/3 • Height^1/2). The purpose of this cross-sectional study was to determine the utility of ABSI as a predictor or modifiable risk factor of CVD compared to other commonly used measures in clinical practice.

Methods: The sample population was from the baseline interview and health examination included in the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Patients (n=5,924, 52% female) were aged 18-80 years (47.4 ± 18.4 years) who completed a series of questionnaires on a spectrum of health-related risks. After the interview, health technicians performed a standardized examination of the participants to collect data on weight, height, BMI, WC, and sagittal abdominal diameter (SAD). Statistical analysis was done using R Studio, version 0.99.903 (RStudio, Inc. Boston, MA). Using logistic regression, the correlation between each predictor (ABSI, BMI, WC, SAD) as a continuous variable, and CVD outcomes was evaluated with two models: a univariable model and a multivariable model. In a secondary analysis, ABSI was reclassified into categorical values based on quartiles of the NHANES dataset. Logistic regressions were again run for overall CVD and all CVD sub-categories, followed by chi-square tests for significance. For comparison, BMI categories of normal, overweight, obese, and severely obese were tested with overall CVD and all CVD subcategories as outcome measures, followed by chi-square tests for significance.

Results: Approximately 10% of the sample population had at least one prior manifestation of CVD, the most common being myocardial infarction (MI) (4.0%). ABSI showed little correlation with weight, BMI, WC, and SAD (r<0.3), while BMI had a strong correlation with weight, BMI, WC, and SAD (r ≈ 0.9). In univariable logistic regression, ABSI showed the most robust associations of all predictors with overall CVD and all CVD subcategories. ABSI demonstrated stronger correlations than BMI for all CVD outcomes (except CHF in the multivariable model). This study attempted to create classifications of ABSI and compare them to the normative classifications of BMI. In this categorical analysis, ABSI was also stronger than BMI in all logistic regression analyses for CVD outcomes, except for CHF in the multivariable model. Severe obesity (BMI ≥40 kg/m²) almost doubled the odds of having CVD, while being categorized in Q2, Q3, and Q4 for ABSI increased odds by double, triple, and eight-fold, respectively.

Conclusion: An ABSI parameter in the upper three quartiles increases the risk of CVD manifestations more significantly than an elevated BMI per category of overweight, obese, and severely obese, respectively. Since the categories for ABSI were created based on quartiles of a large sample size reflecting the US population, this suggests that the increased risk from an elevated ABSI is more widespread than previously understood. Thus, ABSI should be monitored more closely and managed in preventative medical care than BMI alone.

Weight-to-height ratio and body roundness index are superior indicators to assess cardio-metabolic risks in Chinese children and adolescents: compared with body mass index and a body shape index

OBJECTIVE

To assess the relationship between five anthropometric indicators, which includes body mass index (BMI), weight-to-height ratio (WHtR), a body shape index (ABSI), ABSI-adolescents, and body roundness index (BRI) in Chinese children and adolescents, and select which could better predict cardio-metabolic risk factors (CMRFs).

METHODS

Cross-sectional study with 1,587 participants aged 3 to 17 years. Five anthropometric indicators were calculated according to weight, height and waist circumference (WC). Anthropometric measurements and laboratory indicators were used to diagnose CMRFs, which included hypertension, dyslipidemia, impaired fasting glucose and abdominal obesity. Partial correlation analysis was used to evaluate the relationship among anthropometric indicators, area under the receiver operating characteristic curve (AUCs) were used to compare the predict ability of each anthropometric indicators, the cut-off value, sensitivity, specificity and Youden Index of each indicator were calculated.

RESULTS

In 3-6 years old children, ABSI-adolescent positively correlated with WC (r=0.727, P<0.001), BMI (r=0.218, P<0.001) and WHtR (r=0.752, P<0.001), and in 7-17 years old participants, the correlation coefficients increased to 0.842, 0.563 and 0.850 (P<0.001), respectively. BRI were strong correlated with BMI, WHtR and ABSI-adolescents in both age group (P<0.001). In 3-6 years group, the ROC analysis showed that BMI and ABSI were significantly better in identifying hypertension in both genders, WHtR and BRI were significantly better in identifying abdominal obesity in girls, but all of them were failed in identifying dyslipidemia and hyperglycemia. In 7-17 years group, WHtR and BRI were significantly better in identifying hypertension, dyslipidemia, abdominal obesity in both genders, BMI and ABSI performed better in identifying hyperglycemia in girls.

CONCLUSIONS

In Chinese children aged 3-6 years, there is no indicator performed best in all the CMRFs, in 7-17 years old teenagers, WHtR and BRI can be recommended to identify hypertension, dyslipidemia, abdominal obesity and clustered CMRFs in both genders. However, ABSI showed weak discriminative power.

Prevalence of Cardiometabolic Syndrome and its Association With Body Shape Index and A Body Roundness Index Among Type 2 Diabetes Mellitus Patients: A Hospital-Based Cross-Sectional Study in a Ghanaian Population

Cardiometabolic syndrome (MetS) is closely linked to type 2 diabetes mellitus (T2DM) and is the leading cause of diabetes complications. Anthropometric indices could be used as a cheap approach to identify MetS among T2DM patients. We determined the prevalence of MetS and its association with sociodemographic and anthropometric indices among T2DM patients in a tertiary hospital in the Ashanti region of Ghana. A comparative cross-sectional study was conducted among 241 T2DM outpatients attending the Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital for routine check-up. Sociodemographic characteristics, clinicobiochemical markers, namely, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and glycated hemoglobin (HbA1C) were measured. Anthropometric indices, namely, body mass index (BMI), Conicity index (CI), body adiposity index (BAI), A body shape index (ABSI), body roundness index (BRI), Waist-to-hip ratio (WHR), and Waist-to-height ratio (WHtR) were computed based on either the Height, Weight, Waist circumference (WC) or Hip circumference (HC) of the patients. Metabolic syndrome (MetS) was classified using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. Data entry and analysis were done using Excel 2016 and SPSS version 25.0 respectively. Of the 241 T2DM patients, 99 (41.1%) were males whereas 144 (58.9%) were females. The prevalence of cardiometabolic syndrome (MetS) was 42.7% with dyslipidemia and hypertension recording a prevalence of 6.6 and 36.1%, respectively. Being a female T2DM patient [aOR = 3.02, 95%CI (1.59-5.76), p = 0.001] and divorced [aOR = 4.05, 95%CI (1.22-13.43), p = 0.022] were the independent sociodemographic predictors of MetS among T2DM patients. The 4th quartile for ABSI and 2nd to 4th quartiles for BSI were associated with MetS on univariate logistic regression (p <0.05). Multivariate logistic regression identified the 3rd quartile (aOR = 25.15 (2.02-313.81), p = 0.012) and 4th quartile (aOR = 39.00, 95%CI (2.68-568.49), p = 0.007) for BRI as the independent predictors of MetS among T2DM. The prevalence of cardiometabolic syndrome is high among T2DM patients and this was influenced by female gender, being divorced, and increased BRI. Integration of BRI as part of routine assessment could be used as early indicator of cardiometabolic syndrome among T2DM patients.

Anthropometric and Body Composition Measurements Related to Osteoporosis in Geriatric Population

Objective:

This study aimed to evaluate different anthropometric and body composition measurements, including weight, body mass index (BMI), body fat percentage (fat%), skeletal muscle index (SMI), a body shape index (ABSI), waist circumference (WC), and hip circumference (HC), in relation to bone mineral density.

Methods:

This is a cross-sectional study of a total of 482 patients who consulted the geriatric outpatient clinic between 2018 and 2019. Patients were evaluated with dual-energy X-ray absorptiometry. Anthropometric measurements (HC, WC, weight, BMI, and ABSI), as well as body composition analysis (fat% and SMI) by bioimpedance analysis system, were performed. The patients were evaluated with the rapid Assessment of Physical Activity Index in terms of aerobic exercise habits.

Results:

There was a significant correlation between lumbar spine (LS) T-score and SMI (r=0.36, p=0.000) and between LS T-score and weight (r=0.21, p=0.000), BMI (r=0.10, p=0.045) and WC (r=0.15, p=0.001). There was a statistically significant correlation between femur neck (FN) T-score and fat% (r=0.15, p=0.001), SMI (r=0.15, p=0.010), weight (r=0.22, p=0.000), BMI (r=0.20, p=0.000), WC (r=0.14, p=0.003), and HC (r=0.17, p=0.001). There was no statistically significant correlation between physical activity and LS T-score (n=353, r=0.08, p=0.16) and FN T-score (n=360, r=0.03, p=0.53). In multiple regression analysis, SMI contributes most in predicting FN and LS T-scores.

Conclusions:

Anthropometric measurements should be carefully selected in the geriatric population. Among the measurements, the strongest relationship was found between LS T-score and SMI.

Visceral adiposity index outperforms conventional anthropometric assessments as predictor of diabetes mellitus in elderly Chinese: a population-based study

Background

This study assessed the performance of visceral adiposity index and body shape index in predicting diabetes mellitus (DM) risk and compared their predictive ability to that of body mass index and waist circumference.

Methods

Among 8249 consecutive subjects who attended the Nationwide Health Check Up System for Senior Citizens (≥ 65 years) between 2008 and 2018, we examined the associations of several adiposity indices with DM risk and explored gender differences.

Results

Among all adiposity indicators, Chinese visceral adiposity index (CVAI) demonstrated the highest discriminatory ability for diabetes mellitus with area under receiver operating characteristic curves (AUC) of 0.65, 0.68, and 0.66 for men, women, and all participants, respectively, and optimal cut-offs set as 126.09 in men and 117.77 in women. Compared with body shape index (ABSI), both CVAI and VAI were strongly associated with baseline DM (adjusted OR: 4.85, 95% CI: 4.05–5.82 and 4.22, 95% CI: 3.53–5.05 for 4th vs 1st quartile groups by CVAI and VAI, P < 0.001), which was more pronounced in older adult women (P_interaction < 0.05). Over a median of 5.25 years (IQR: 3.07–6.44 years) follow-up, Cox regression models showed higher predictive ability of CVAI and VAI compared to ABSI. Further, both CVAI and VAI independently predicted new-onset DM (adjusted HR: 1.29, 95% CI: 1.22–1.37 and 1.16, 95% CI: 1.11–1.21 by CVAI and VAI) and composite endpoint of new DM and death among those without baseline DM.

Conclusions

Our population-based data demonstrated that Chinese visceral adiposity index may serve as a superior clinical indicator of diabetes when compared with conventional anthropometric indices among older adult Chinese, especially in women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12986-021-00608-6.

Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review

Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.

Association between measures of adiposity and blood pressure levels in adult Cameroonians

INTRODUCTION

Several anthropometric measurements are variably recommended to assess adiposity in routine practice, with less agreement on their comparative performance. We assessed and compared the relationship of seven anthropometric measures of adiposity-waist circumference (WC), waist-to-height ratio (WHtR), Body Mass Index (BMI), Ponderal Index (PI), Conicity Index (C index), A Body Shape Index (ABSI), and Body Roundness Index (BRI)-with blood pressure (BP) levels and prevalent hypertension in adult Cameroonians.

METHODS

Data were collected as Cameroon's contribution to the global May Measurement Month 2017(MMM17) survey. Participants were nonpregnant adults, who had no BP measurement in the past year and with no prior hypertension diagnosis. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic ≥90 mm Hg. Odds ratios (ORs) for the presence of hypertension per 1 SD increase in each adiposity metrics were estimated in separate logistic regression models. Assessment and comparison of discrimination used the area under the receiver operating characteristics curve (AUC) and nonparametric methods.

RESULTS

We included 14 424 participants (8210 [58.25%] female; 39.84 ± 14.33 years). There was a graded association between measures of adiposity and prevalent screen-detected (newly diagnosed) hypertension, with effect sizes being mostly within the same range across measures of adiposity. AUC for hypertension prediction ranged from 0.709 with PI to 0.721 with BRI for single measures, and from 0.736 to 0.739 with combinations of measures of adiposity.

CONCLUSION

WC, WHtR, and BRI were strongly associated with BP and better predicted prevalent hypertension, with effects enhanced with the inclusion of BMI.

Subclinical Hypothyroidism Represents Visceral Adipose Indices, Especially in Women With Cardiovascular Risk

Context

From previous studies, decreased thermogenesis and metabolic rate in the patients with overt and subclinical hypothyroidism lead to an increase in visceral adipose tissue (VAT) incidence, and which was associated with cardiovascular diseases. In this paper, we want to explore the relationship between various forms of VAT [pericardial (PCF), and thoracic periaortic adipose tissue (TAT)] and obesity indices [body shape index (ABSI), and body roundness index (BRI), Chinese visceral adiposity index (CVAI)] with subclinical hypothyroidism by gender.

Objective

This study aims to evaluate region-specific cardiovascular (CV) fat tissue (pericardial fat [PCF] and thoracic periaortic fat [TAT) and noninvasive visceral adipose indices (a body shape index [ABSI], body roundness index [BRI]), and Chinese visceral adiposity index [CVAI]) in patients with subclinical hypothyroidism (SCH) as compared to a control population and relative to variations in CV risk.

Methods

A total of 125 Taiwanese patients recently diagnosed with SCH (age: 52.9 ± 10.16 years, 41.6% female) and 1519 healthy volunteers (age: 49.54 ± 9.77 years, 29.0% female) were evaluated for this study. All participants underwent PCF and TAT assessment using a multidetector computed tomography scanner, ABSI, BRI, and CVAI evaluation using a mathematical formula. CV risk was classified by Framingham risk score (FRS).

Results

Multivariable logistic regression models showed that the independent association of TAT and BRI with SCH were stronger in women than men. The adjusted model associations (odds ratio [OR]; 95% CI) with SCH for TAT and BRI in women were 2.61 (95% CI, 1.03-6.97) and 2.04 (95% CI, 1.07-3.92). The incidences of TAT and BRI third tertile were also higher in women with SCH (SCH vs euthyroid, TAT third tertile, 9 [17.3%] vs 35 [7.9%], P = .04; BRI third tertile, 22 [42.3%] vs 111 [25.2%], P = .01). In addition to BRI and TAT, there were higher risks of CVAI in SCH with intermediate/high FRS, especially in women (OR; 95% CI, TAT: 4.01; 95% CI, 1.01-6.640; BRI: 6.91; 95% CI, 1.03-10.23; CVAI: 7.81 95% CI, 1.01-12.03).

Conclusion

Our findings show that patients with SCH have significantly greater TAT, BRI, and CVAI values than control groups, especially in women (with different FRS).

Importance of Anthropometric Measurements to Determine Cardiometabolic Diseases in Obstructive Sleep Apnea Syndrome

OBJECTIVE

Obesity is considered a major risk factor for obstructive sleep apnea syndrome (OSAS). This study aimed to examine the correlation between anthropometric measurements, which have been recently defined and are indicative of abdominal obesity and cardiometabolic diseases, OSAS severity, and polysomnography (PSG) parameters in patients with OSAS.

MATERIAL AND METHODS

This retrospective cohort study included patients who underwent all-night polysomnography with a prediagnosis of OSAS. These patients were categorized as having mild (5-15), moderate (15-30), and severe (>30) OSAS according to the apnea-hypopnea index (AHI). The anthropometric measurements used in the study consisted of waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), (waist/hip)-to-height ratio (WHHR), a body shape index (ABSI), body adiposity index (BAI), abdominal volume index (AVI), and conicity index (CI).

RESULTS

A total of 410 individuals were enrolled in the study (31 control subjects and 129 with mild, 101 with moderate, and 149 with severe OSAS). A significant difference was observed between groups in terms of all anthropometric measurements (p<0.05). The difference between the groups was significant in terms of diabetes mellitus, hypertension, and cardiovascular disease (p<0.05). There was a significant correlation between each of the anthropometric measurements and the PSG parameters. In the receiver operating characteristic analysis, cutoff values that predicted severe OSAS were ABSI>0.08, BAI>28.29, AVI>25.54, and CI>1.37. Multiple regression analyses demonstrated that age, sex, and AVI were independent predictors that determine OSAS presence.

CONCLUSION

Anthropometric parameters that are indicators of abdominal obesity were found to be robustly correlated with cardiometabolic diseases and the severity of OSAS.

Prevalence of obesity and an interrogation of the correlation between anthropometric indices and blood pressures in urban Lagos, Nigeria

Adverse cardiovascular outcomes are linked to higher burden of obesity and hypertension. We conducted a secondary analysis of data for 5135 participants aged ≥ 16 years from our community-based hypertension prevalence study to determine the prevalence of obesity and association between multiple anthropometric indices and blood pressure (BP). The indices were waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), a body shape index(ABSI), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI), visceral adiposity index (VAI) and conicity index (CI). We performed statistical analyses to determine the association, predictive ability, cutoff values and independent determinants of hypertension. Crude prevalence of obesity was 136 per 1000 (95% confidence interval 126-146). BMI had the strongest correlation with systolic and diastolic BP (r_s = 0.260 and 0.264, respectively). Indices of central adiposity (AVI, WC, WHtR, BRI) were the strongest predictors of hypertension (≥ 140/90 mmHg), and their cut-off values were generally higher in females than males. WHR, age, BMI and CI were independent determinants of hypertension ≥ 140 mmHg (p < 0.05). We conclude that, based on this novel study, measures of central adiposity are the strongest predictors and independent determinants of hypertension in our population, and cut-off values vary from previously recommended standards.

A body shape index (ABSI) and endometrial pathology

A body shape index (ABSI) is an anthropometric measure that allows evaluating abdominal adiposity. Obesity is considered a risk factor for endometrial cancer (EC). Due to the increase in EC's incidence, identifying risk factors for endometrial pathology is essential in women's health. The study aimed to identify an association between EC/endometrial pathology and ABSI. We identified well-known risk factors for endometrial cancer and calculated ABSI in 408 women who were admitted to the Polish Mother's Memorial Hospital Research Institute between January 2016 and December 2017. Patients were divided into four subgroups: no endometrial pathology, endometrial polyps, hyperplasia without atypia, and hyperplasia with atypia/cancer. Statistical analysis showed a correlation between ABSI and the presence of cancer/atypical hyperplasia (Kruskal-Wallis test, p = .042). Additional multivariate analysis revealed that both ABSI and body mass index (BMI) z scores might potentially be associated with EC presence (ABSI z score quintiles Q1, Q2, Q3 vs. Q4, Q5: p = .039; BMI z score quintiles Q1, Q2, Q3 vs. Q4, Q5: p = .038). We found an association between cancer/atypical hyperplasia and ABSI. Further studies on ABSI are needed to establish ABSI as a risk factor for EC fully.

The relationship between nocturnal blood pressure drop and body composition indices among hypertensive patients

Among hypertensive subjects, the lack of physiological blood pressure drop as part of diurnal blood pressure variations is termed as non-dipper blood pressure. Herein, we investigated the relationship between hypertension character and body composition indices. This study included a total of 104 patients (54 M, mean age: 47.6 ± 12.1 years). Patients' heights, weights, and waist and hip circumferences were measured, and body composition indices were calculated. All patients' office blood pressure measurements and 24-hour ambulatory blood pressure readings were recorded. A blood pressure drop of at least 10% compared with daytime blood pressure readings is called dipper blood pressure, while a drop of less than 10% is termed as non-dipper blood pressure. Based on ambulatory blood pressure readings, the patients were grouped into Group 1 (dipper pattern; 51 pts, 34 M, mean age 45.6 ± 12.3) and Group 2 (non-dipper pattern, 53 pts; 20 M, mean age 49.6 ± 11.6). The proportion of females and smokers were significantly lower in Group 1 than Group 2. BRI, BAI, waist-to-height ratio, and waist circumference were significantly higher in Group 2 than Group 1. There were significant positive correlations between body roundness index (BRI), body adiposity index (BAI), waist-to-weight ratio, and WC and nocturnal mean systolic and diastolic blood pressure readings. Percent systolic nocturnal drop was significantly correlated with waist-to-height ratio, BAI, and BRI. Similarly, percent diastolic nocturnal drop and waist-to-height ratio, BAI, and BRI were correlated. In conclusion, the relatively new body composition indices, namely BRI and BAI, are more closely related to nocturnal blood pressure readings among non-dipper subjects.

A new anthropometric index to predict percent body fat in young adults

OBJECTIVE

To propose a new anthropometric index that can be employed to better predict percent body fat (PBF) among young adults and to compare with current anthropometric indices.

DESIGN

Cross-sectional.

SETTING

All measurements were taken in a controlled laboratory setting in Seoul (South Korea), between 1 December 2015 and 30 June 2016.

PARTICIPANTS

Eighty-seven young adults (18-35 years) who underwent dual-energy x-ray absorptiometry (DXA) were used for analysis. Multiple regression analyses were conducted to develop a body fat index (BFI) using simple demographic and anthropometric information. Correlations of DXA measured PBF (DXA_PBF) with previously developed anthropometric indices and the BFI were analysed. Receiver operating characteristic curve analyses were conducted to compare the ability of anthropometric indices to identify obese individuals.

RESULTS

BFI showed a strong correlation with DXA_PBF (r = 0·84), which was higher than the correlations of DXA_PBF with the traditional (waist circumference, r = 0·49; waist to height ratio, r = 0·68; BMI, r = 0·36) and alternate anthropometric indices (a body shape index, r = 0·47; body roundness index, r = 0·68; body adiposity index, r = 0·70). Moreover, the BFI showed higher accuracy at identifying obese individuals (area under the curve (AUC) = 0·91), compared with the other anthropometric indices (AUC = 0·71-0·86).

CONCLUSIONS

The BFI can accurately predict DXA_PBF in young adults, using simple demographic and anthropometric information that are commonly available in research and clinical settings. However, larger representative studies are required to build on our findings.

Different adiposity indices and their associations with hypertension among Chinese population from Jiangxi province

BACKGROUND

To date, the best adiposity index that predicts or associates strongly with hypertension remains controversial. Therefore, we aimed to compare the performance of different adiposity indices [BMI (body mass index), WC (waist circumference), WHtR (waist-to-height ratio), ABSI (a body shape index), VAI (visceral adipose index), BFP (body fat percentage)] as associates and potential predictors of risk of hypertension among Chinese population.

METHODS

A cross-sectional survey was conducted in Jiangxi province, China from 2013 to 2014. A total of 14,573 participants were included in the study. The physical measurements included body height, weight, WC, BFP and VAI. Multivariate logistic regression analysis was performed to assess the associations between different adiposity indices and the prevalence of hypertension. Receiver operating characteristic (ROC) analysis was also performed.

RESULTS

All adiposity indices were independently and positively associated with the prevalence of hypertension in a dose response fashion. The area under the curves (AUCs) for WHtR, BFP and VAI were significantly larger than those for other adiposity indices in both males and females (all P < 0.01). For males, no statistically significant difference was found in AUCs among WHtR and BFP (0.653 vs. 0.647, P = 0.4774). The AUC of WHtR was significantly higher than VAI (0.653 vs. 0.636, P < 0.01). For females, the AUCs demonstrated that WHtR was significantly more powerful than BFP and VAI (both P < 0.05) for predicting hypertension [WHtR, 0.689 (0.677-0.702); BFP, 0.677 (0.664-0.690); VAI, 0.668 (0.655-0.680)]. Whereas no significant differences were found in AUCs for hypertension among BFP and VAI in both sexes (all P > 0.1). The AUCs for hypertension associated with each adiposity index declined with age in both males and females. For subjects aged < 65 years, WHtR still had the largest AUC. However, for participants aged ≥65 years, BMI had the largest AUC.

CONCLUSION

The findings indicated that WHtR was the best for predicting hypertension, followed by BFP and VAI, especially in younger population.

Comparisons of body mass index, waist circumference, waist-to-height ratio and a body shape index (ABSI) in predicting high blood pressure among Malaysian adolescents: a cross-sectional study

OBJECTIVE

To compare the performance of different anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and a body shape index to predict high blood pressure (BP) in adolescents using the 90th and 95th percentiles as two different thresholds.

DESIGN

Cross-sectional study.

SETTING

Probability proportionate to size was used to randomly select two schools in Selangor state, Malaysia.

PARTICIPANTS

A total of 513 adolescents (58.9% women and 41.1% men) aged 12-16 years were recruited.

PRIMARY AND SECONDARY OUTCOME MEASURES

Weight, height, WC and BP of the adolescents were measured. The predictive power of anthropometric indices was analysed by sex using the receiver operating characteristic curve.

RESULTS

BMI and WHtR were the indices with higher areas under the curve (AUCs), yet the optimal cut-offs to predict high BP using the 95th percentile were higher than the threshold for overweight/obesity. Most indices showed poor sensitivity under the suggested cut-offs. In contrast, the optimal BMI and WHtR cut-offs to predict high BP using the 90th percentile were lower (men: BMI-for-age=0.79, WHtR=0.46; women: BMI-for-age=0.92, WHtR=0.45). BMI showed the highest AUC in both sexes but had poor sensitivity among women. WHtR presented good sensitivity and specificity in both sexes.

CONCLUSIONS

These findings suggested that WHtR might be a useful indicator for screening high blood pressure risk in the routine primary-level health services for adolescents. Future studies are warranted to involve a larger sample size to confirm these findings.

Joint Effects of Body Mass Index and Waist Circumference on the Incidence of Hypertension in a Community-Based Chinese Population

OBJECTIVE

We aimed to investigate the relationships of body mass index (BMI), waist circumference (WC), and obesity defined using a combination of both indexes, with the incidence of hypertension in a Chinese community-based population.

METHODS

A total of 1,927 Chinese participants (57.2 ± 8.9 years old) with normal blood pressure at baseline were recruited from the Shijingshan community in Beijing. Incident hypertension was defined as blood pressure ≥140/90 mm Hg, self-reported hypertension, or the use of any antihypertensive medication at the follow-up visit.

RESULTS

During 2.3 years of follow-up, 19.1% (n = 97) of the men and 13.6% (n = 158) of the women developed incident hypertension. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for obesity (BMI ≥30) were 3.49 (1.59-7.66) and 2.60 (1.48-4.55) for men and women, respectively. A 1-point increase in BMI was associated with 8% (OR = 1.08, 95% CI: 1.00-1.17) and 10% (OR = 1.10, 95% CI: 1.05-1.16) increases in the incidence of hypertension in men and women, respectively. Abdominal obesity (WC ≥90 cm in men and ≥85 cm in women) was positively associated with incident hypertension in both men (adjusted OR = 1.79, 95% CI: 1.10-2.91) and women (adjusted OR = 1.61, 95% CI: 1.09-2.40). A 1-cm increase in WC was associated with 4% (adjusted OR = 1.04, 95% CI: 1.01-1.07) and 4% (adjusted OR = 1.04, 95% CI: 1.02-1.07) increases in the incidence of hypertension in men and women, respectively. The combination of abnormal BMI and WC has the highest risk for hypertension in both men (adjusted OR = 3.10, 95% CI: 1.48-6.50) and women (adjusted OR = 2.51, 95% CI: 1.43-4.40).

CONCLUSIONS

This study shows that BMI, WC, and an index that combined the two are independently associated with incident hypertension in a Chinese community-based population.

Predictive Values of Anthropometric Measurements for Cardiometabolic Risk Factors and Cardiovascular Diseases Among 44 048 Chinese

Background The predictive value of adiposity indices and the newly developed index for cardiometabolic risk factors and cardiovascular diseases (CVDs) remains unclear in the Chinese population. This study aimed to compare the predictive value of A Body Shape Index with other 5 conventional obesity-related anthropometric indices (body mass index, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio) in Chinese population. Methods and Results A total of 44 048 participants in the study were derived from the baseline data of the PURE-China (Prospective Urban and Rural Epidemiology) study in China. All participants' anthropometric parameters, CVDs, and risk factors (dyslipidemia, abnormal blood pressure, and hyperglycemia) were collected by standard procedures. Multivariable logistic regression models and receiver operator characteristic curve analysis were used to evaluate the predictive values of obesity-related anthropometric indices to the cardiometabolic risk factors and CVDs. A positive association was observed between each anthropometric index and cardiometabolic risk factors and CVDs in all models (P<0.001). Compared with other anthropometric indices (body mass index, waist circumference, hip circumference, waist-to-hip ratio, and A Body Shape Index), waist-to-height ratio had significantly higher areas under the curve (AUCs) for predicting dyslipidemia (AUCs: 0.646, sensitivity: 65%, specificity: 44%), hyperglycemia (AUCs: 0.595, sensitivity: 60%, specificity: 45%), and CVDs (AUCs: 0.619, sensitivity: 59%, specificity: 41%). Waist circumference showed the best prediction for abnormal blood pressure (AUCs: 0.671, sensitivity: 66%, specificity: 40%) compared with other anthropometric indices. However, the new body shape index did not show a better prediction to either cardiometabolic risk factors or CVDs than that of any other traditional obesity-related indices. Conclusions Waist-to-height ratio appeared to be the best indicator for dyslipidemia, hyperglycemia, and CVDs, while waist circumference had a better prediction for abnormal blood pressure.

ABSI is a poor predictor of insulin resistance in Chinese adults and elderly without diabetes

OBJECTIVE

Recently, a new obesity index (A Body Shape Index, ABSI) based on waist circumference (WC) was developed, and high ABSI corresponds to a more central concentration of body volume. It is well known that central obesity is closely linked with insulin resistance (IR). Therefore, our study aimed to examine the discriminatory power of ABSI for IR in Chinese adults and elderly without diabetes.

SUBJECTS AND METHODS

In 2007, a cross-sectional study was made. In this study, 570 individuals without diabetes were available for analysis (male: 56.1%, mean age: 62.3 ± 6.5 years). Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). Areas under the receiver operating characteristic (ROC) curves were determined to identify variables/models that could predict insulin resistance.

RESULTS

ABSI was associated with IR, the cut-off points was 0.0785 m11/6kg-2/3 to identifying IR and the area under the ROC (AUC) curve was 0.618 (95%CI: 0.561-0.675), which was not better than body mass index BMI (AUC = 0.753; 95%CI: 0.706-0.801), WC (AUC = 0.749; 95%CI: 0.700-0.797), and fasting plasma glucose (FPG, AUC = 0.752; 95%CI: 0.705-0.799). Furthermore, combination with ABSI could improve the discriminatory power of other variables for IR. The AUC curve increased from 0.753 to 0.771for BMI, 0.749 to 0.754 for WC, 0.752 to 0.769 for FPG, respectively.

CONCLUSIONS

ABSI is associated with IR in the general Chinese adults and elderly without diabetes, but the discriminatory power for IR is poor. It is recommended that ABSI be used in combination with other variables.

A novel adiposity index as an integrated predictor of cardiometabolic disease morbidity and mortality

We propose a new anthropometric index, weight-adjusted-waist index (WWI), to assess adiposity by standardizing waist circumference (WC) for weight. WWI, calculated as WC (cm) divided by the square root of weight (kg) (cm/√kg), was measured from 465,629 subjects in the Korean nationwide cohort (2008-2013). Cox regression analysis was used to compare WWI with BMI, WC, waist-to-height ratio (WHtR), and a body shape index (ABSI) for cardiometabolic morbidity and mortality risk in diagnostic and prognostic prediction models. For incident hypertension, type 2 diabetes and cardiovascular disease (CVD), BMI had the strongest predictive power, followed by WWI and WC. However, WWI showed the best predictive performance for CVD mortality. Also, a linear positive association between adiposity indices and cardiovascular and all-cause mortality was only shown in WWI and ABSI, not BMI, WC and WHtR which showed inverse J-shaped patterns. In the test of joint effects of each index, WWI combined with BMI was the strongest in both diagnostic and prognostic models. WWI is a unique adiposity index that shows linear positive association with both cardiometabolic morbidity and mortality. It also predicts incident cardiometabolic disease, cardiovascular and all-cause mortality risk with excellence in predictive power, especially when combined with BMI.

A body shape index and vascular structure and function in Spanish adults (MARK study): A cross-sectional study

A body shape index (ABSI) has been introduced as a marker of the relationship between body composition and all-cause mortality. However, until now, the relationships between ABSI and vascular structure and function have not been evaluated. The aim of this study was to investigate the association of ABSI with vascular structure and function in Spanish adults with intermediate cardiovascular risk. This cross-sectional study analyzed the data of 2354 subjects [age, 35-74 years (median, 62.0 years [range, 56.0-67.0 years]), 61.9% men] enrolled into the MediAte Risk management (MARK) study. ABSI was calculated by using the following formula: ABSI = waist circumference (m)/[body mass index × height (m))]. Vascular function was assessed by measuring cardio-ankle vascular index (CAVI) with the VaSera device and brachial ankle pulse wave velocity (baPWV) by using a validated equation. Vascular structure was assessed by measuring carotid intima-media thickness (IMT) by ultrasonography. Median value of ABSI was 0.083 (range, 0.081-0.090), mean CAVI was (8.5 ± 1.2), and median IMT was 0.727 (range, 0.672-0.799). The values of ABSI and CAVI were higher in men. After adjusting for confounders, ABSI was positively associated with CAVI, baPWV, and average mean IMT. Thus, for each unit increase in ABSI, CAVI increased by 0.16 units, baPWV by 0.25 m/s, and IMT by 0.033 mm. In the logistic regression analysis, the odds ratio of ABSI was > 1 for high CAVI ≥ 9, baPWV ≥ 15 m/s, and IMT ≥ 0.90 mm in the overall subject group, and in the sex- and age-specific (> 62 years, ≤ 62 years) subgroups, after adjusting for confounders. The area under the receiver-operating characteristic curve of the ABSI was 0.631 (95% confidence interval [CI], 0.608-0.654) for CAVI ≥ 9, and 0.617 (95% CI, 0.593-0.641) for high baPWV ≥ 15 m/s. ABSI showed a positive association with vascular structure and function, independent of other confounders that might influence weight and fat mass distribution in Spanish subjects at intermediate cardiovascular risk.Trial Registration: ClinicalTrials.gov Identifier: NCT01428934 (registered: September 2, 2011; last updated: September 8, 2016).

A comparison of the sensitivity and specificity of anthropometric measurements to predict unhealthy metabolic phenotype in overweight and obese women

AIM

Metabolically Healthy Obese (MHO) is called to obese people that their insulin sensitivity, lipid profiles and inflammatory profiles are favorable, and there are no signs of hypertension and cardio-metabolic diseases. The metabolically unhealthy obese (MUHO) is the opposite. A Body Shape Index (ABSI) is a marker to identifying abdominal obesity that is derived from weight, height and waist circumference (WC). Several studies have reported ABSI is associated with diabetes, metabolic syndrome, hypertension and higher mortality rate.

MATERIALS AND METHODS

A total of 305 overweight and obese women were included in the current comparative cross-sectional study. Body composition was measured using body composition analyzer. Blood samples were obtained. The usual food intake of evaluated through the use of a semi-quantitative food frequency questionnaire.

RESULTS

The results of this study revealed that there is a significant relationship between ABSI and MHO and MUHO (p = 0.04) and area under the ROC curve was 0.60. Also there is a significant relationship between BMI, fat mass index (FMI), free fat mass index (FFMI), neck circumference (NC), WC, fat mass (FM) and metabolic healthy status (MHS). The largest area under the ROC curve belonged to NC, WC, FM and BMI (0.66).

CONCLUSION

The findings of this study suggest that there is a significant relationship between ABSI, BMI, FMI, FFMI, NC, WC, FM and MHS. The largest area under the ROC curve was related to the NC, WC, FM and BMI not ABSI, that means NC, WC, FM and BMI have maximum sensitivity and specificity.

Pathways from Food Consumption Score to Cardiovascular Disease: A Seven-Year Follow-Up Study of Indonesian Adults

Background: Available prospective studies of food insecurity and cardiovascular diseases (CVD) have included obesity and hypertension as the modifiable risk factors. Studies using the physical activity measures are lacking, and where to contribute to counterbalance the risk associated with food insecurity and CVD remains unclear. We aimed to use structural equation modelling (SEM) to explore the complex direct and indirect factor variables influencing cardiovascular disease (CVD) during a seven-year follow-up study. Methods: For 3955 adults who participated in the Indonesian Family Life Surveys in 2007 and 2014, we used SEM to examine the direct and indirect relationships of food consumption score, body shape index, physical activity volume, and blood pressures on CVD. Results: Based on the beta coefficients from a regression analysis, the significant direct effects (p < 0.001) for CVD were food consumption score (FCS), a body shape index (ABSI), vigorous physical activity volume (VPAV), and systolic blood pressure (SBP). Indirect (p = 0.004–p < 0.001) effects for CVD were FCS, ABSI, moderate physical activity volume (MPAV), and VPAV. Food-insecure people are more likely to consume high-calorie diets that lead to obesity, which, together with a lack of vigorous physical activity, leads to hypertension and CVD. Conclusions: Of the multiple factors influencing CVD, the modifiable risk factors were FCS, ABSI, and VPAV. Hence, the recommendations for CVD prevention should include targeting food insecurity, body shape index, and vigorous physical activity besides the measurement of blood pressure.

Assessing a new hip index as a risk predictor for diabetes mellitus

AIMS/INTRODUCTION

Recently, a new anthropometric parameter (a new hip index [HI]) was developed, and the HI shows a U-shaped relationship to mortality in the USA population. It is well known that there is an inverse relationship between hip circumference (HC) and the risk of diabetes mellitus. Accordingly, the study sought to investigate whether HI could predict future diabetes mellitus, as compared with HC and the waist-to-hip ratio (WHR), in a general Chinese population.

MATERIALS AND METHODS

In 2007, we carried out a health examination of 687 participants (mean age 48.1 ± 6.2 years, male 58.1%). Development of diabetes mellitus by the 2007 examination was studied in relation to data from a baseline health examination carried out in 1992.

RESULTS

During the follow up, 74 participants were diagnosed with diabetes mellitus. Across the quintiles of baseline HI, the incidence rates of diabetes mellitus were 12.4, 12.4, 9.9, 7.8 and 11.3% in quintile (Q)1, Q2, Q3, Q4 and Q5, respectively (P = 0.698). With the lowest quintile (Q1) as reference, univariate and multivariate Cox regression analyses showed that HI was not associated with diabetes mellitus. In contrast, HC and WHR could predict future diabetes mellitus. Furthermore, WHR had the best discriminatory power for diabetes mellitus (area under the receiver operating characteristic curve 0.691, 95% confidence interval 0.621-0.761), followed by HC (area under the receiver operating characteristic curve 0.623, 95% confidence interval 0.558-0.689) and HI (area under the receiver operating characteristic curve 0.464, 95% confidence interval 0.396-0.531).

CONCLUSIONS

Compared with HC and WHR, HI was not an independent risk factor for diabetes mellitus in the Chinese population. More studies are required to delineate the limits of the utility of HI.

The feasibility of two anthropometric indices to identify metabolic syndrome, insulin resistance and inflammatory factors in obese and overweight adults

OBJECTIVES

A body shape index (ABSI) and body roundness index (BRI) were reported to predict diabetes and hypertension in general population, but their validity was regularly questioned. The aim of this study was to evaluate whether ABSI and BRI are the best anthropometric indices to reflect metabolic syndrome (MetS), insulin resistance (IR), and inflammatory factors in obese and overweight Chinese adults.

METHODS

Cross-sectional data on sociodemographic, lifestyle, anthropometric indices, clinical characteristics, and biochemical measurements were collected for 1442 Chinese obese and overweight adults. Logistic regression analysis examined the associations between anthropometric indices with incidences of MetS and IR in both sexes. Furthermore, the correlation between anthropometric indices and inflammatory factors was assessed.

RESULTS

Multivariate regression analysis depicting BRI and waist circumference (WC) were associated significantly with MetS and IR. BRI had the highest odds ratios (ORs) for IR and WC had the highest ORs for MetS in all anthropometric indices. However, ABSI did not exhibit any association between the MetS and IR. The ABSI adjusted regression coefficients (β values) were 0.403 for high-sensitivity C reactive protein, 0.077 for tumor necrosis factor-α, and 0.022 for interleukin-6. BRI and WC were also significantly associated with three inflammatory factors. Comparing the lowest with the highest quintile, BRI had the largest ORs for MetS (OR, 5.778; 95% confidence interval [CI], 2.954-11.303; P < 0.01) and IR (OR, 6.212; 95% CI, 2.912-13.250; P < 0.01).

CONCLUSION

Only BRI and WC, not ABSI, can significantly determine the presence of MetS and IR. BRI showed the optimal capability to identify IR in obese and overweight population.

Effectiveness of A Body Shape Index (ABSI) in predicting chronic diseases and mortality: a systematic review and meta-analysis

Anthropometric measures are simple, inexpensive, noninvasive tools to assess the risk of morbidity and mortality. This systematic review assessed the performance of A Body Shape Index (ABSI) in predicting hypertension, cardiovascular disease, type 2 diabetes and all-cause mortality and compared the differential predictability between ABSI and two other common anthropometric measures - body mass index and waist circumference. A keyword and reference search were conducted in the PubMed and Web of Science for articles published until 1 November 2017. Thirty-eight studies were included in the review, including 24 retrospective cohort studies and 14 cross-sectional studies conducted in 15 countries. Meta-analysis found that a standard deviation increase in ABSI was associated with an increase in the odds of hypertension by 13% and type 2 diabetes by 35% and an increase in cardiovascular disease risk by 21% and all-cause mortality risk by 55%. ABSI outperformed body mass index and waist circumference in predicting all-cause mortality but underperformed in predicting chronic diseases. ABSI is highly clustered around the mean with a rather small variance, making it difficult to define a clinical cutoff for clinical practice. Future studies are warranted to assess ABSI's potential usefulness as an anthropometric measure in population-level health surveillance.

Untangling Waist Circumference and Hip Circumference from Body Mass Index with a Body Shape Index, Hip Index, and Anthropometric Risk Indicator

Body mass index (BMI) corrects body weight for height and is well established for diagnosing overweight and obesity and correlating with many medical conditions. Waist circumference (WC) is used to diagnose abdominal obesity. However, the correlation of BMI and WC is high, around 0.9, making the use of BMI and WC in concert challenging. A body shape index (ABSI) is a new measure of risk associated with abdominal size. Derived in 2012, ABSI is analogous to BMI in that it normalizes WC for weight and height (and thus to BMI). A similar derivation led to hip index (HI), normalizing hip circumference for BMI. Hazard ratios (HRs) for univariate risk associations of the independent measures height, BMI, ABSI, and HI can be multiplied to give a combined HR, the anthropometric risk indicator (ARI). Compared to any one anthropometric factor, including BMI and WC, ARI more accurately estimates personalized mortality hazard. Published work on ABSI, HI, and ARI supports their association with many aspects of health, including cardiometabolic conditions related to the metabolic syndrome.

New anthropometric indices or old ones: which perform better in estimating cardiovascular risks in Chinese adults

Background

Various anthropometric indices can be used to estimate obesity, and it is important to determine which one is the best in predicting the risk of coronary heart disease (CHD) and to define the optimal cut-off point for the best index.

Methods

This cross-sectional study investigated a consecutive sample of 11,247 adults, who had lived in rural areas of China and were older than 35 years of age. Eight obesity indices, including the body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI) and a body shape index (ABSI) were investigated. The risk of CHD was evaluated by the 10-year coronary event risk (Framingham risk score). Receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive ability of the obesity indices for CHD risk.

Results

Of the whole population, 3636 (32.32%) participants had a risk score higher than 10%. Those who suffered medium or high CHD risk were more likely to have higher mean anthropometric indices, except for BMI in males. In the multivariate-adjusted logistic regression, all these anthropometric measurements were statistically associated with CHD risk in males. After adjusting for all the possible confounders, these anthropometric measurements, except for ABSI, remained as independent indicators of CHD risk in females. According to the ROC analyses, ABSI provided the largest area under the curve (AUC) value in males, and BMI showed the lowest AUC value, with AUC varying from 0.52 to 0.60. WHtR and BRI provided the largest AUC value in female, and similarly, BMI showed the lowest AUC value, with AUC varying from 0.59 to 0.70. The optimal cut-off values were as follows: WHtR (females: 0.54), BRI (females: 4.21), and ABSI (males: 0.078).

Conclusions

ABSI was the best anthropometric index for estimating CHD risk in males, and WHtR and BRI were the best indicators in females. Males should maintain an ABSI of less than 0.078, and females should maintain a WHtR of less than 0.54 or a BRI of less than 4.21.

Electronic supplementary material

The online version of this article (10.1186/s12872-018-0754-z) contains supplementary material, which is available to authorized users.

The Association of Food Consumption Scores, Body Shape Index, and Hypertension in a Seven-Year Follow-Up among Indonesian Adults: A Longitudinal Study

Aims: The concept of food security and its association with chronic diseases are both well-established. During the years within the scope of the study, there was a significant increase in the body shape index (ABSI) of Indonesian adults. This study tested the hypothesis that the association between food security and chronic diseases is mediated, in part, by ABSI. Methods: Data was obtained from 2156 Indonesian adults using the Indonesia Family Life Survey (IFLS) in 2007 and 2014. Longitudinal study participants were interviewed face-to-face for dietary intake data using the food frequency questionnaire (FFQ). Food security, a concept developed by the World Food Programme (WFP), was calculated based on a food consumption score analysis using the FFQ. A generalized estimating equation (GEE) and a Sobel–Goodman test were used to test the hypothesis in this study. Results: The food consumption score was negatively associated with ABSI. It was also negatively associated with systolic blood pressure (p < 0.001). In a formal mediation analysis, ABSI significantly mediated the pathway between the food consumption score and systolic blood pressure (p < 0.001). Conclusions: The effect of food security on hypertension is mediated through body shape. Strategies to improve the prevention of hypertension among adults may need to take the ABSI and food security, along with nutrition education, into account.

Anthropometric patterns of adiposity, hypertension and diabetes mellitus in older adults of Viçosa, Brazil: A population-based study

AIM

To identify anthropometric patterns of adiposity and estimate their association with hypertension and diabetes mellitus (DM) in older adults.

METHODS

A cross-sectional study with 537 older adults aged ≥60 years was carried out. Weight, height, and waist, hip and calf circumference were measured. The following indices were calculated: a body shape index, body roundness index, conicity index, body adiposity index, body mass index, waist-to-height ratio, waist-to-calf ratio, waist-to-hip ratio and waist-to-hip-to-height ratio. The anthropometric patterns of adiposity were obtained by factor analysis of principal components, and their association with hypertension and DM was identified by multiple Poisson regression with robust variance.

RESULTS

Two anthropometric patterns of adiposity were identified. Pattern 1 and 2 explained approximately 53% and 33% of the total variance, respectively, in both sexes. Pattern 1 indicated of global adiposity, and weight, body mass index and hip circumference were the variables most strongly correlated with this pattern in both sexes. Pattern 2 represented the body fat distribution, being a body shape index the most important variable in this factor. After adjustment by confounding factors, only the pattern 2 remained significantly associated with DM in women.

CONCLUSIONS

Only the anthropometric pattern of adiposity central was associated with DM in older women. Geriatr Gerontol Int 2018; 18: 584-591.

Sex- and Age-Specific Optimal Anthropometric Indices as Screening Tools for Metabolic Syndrome in Chinese Adults

OBJECTIVES

To compare the predictive ability of six anthropometric indices for identification of metabolic syndrome (MetS) and to determine their optimal cut-off points among Chinese adults.

METHODS

A total of 59,029 participants were enrolled. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) were measured. Receiver-operating characteristic curves analyses were performed to determine the discriminatory power of these indices for the identification of cardiometabolic risks and diagnosis of MetS. The differences in the area under the curve (AUC) values among the indices were evaluated. The Youden index was used to determine the optimal cut-off points.

RESULTS

WHtR and BRI exhibited the highest AUC values for identifying MetS and most cardiometabolic risk factors in both sexes, whereas ABSI showed the lowest AUC value. The general optimal cut-off points in women were 23.03 kg/m² for BMI, 77.25 cm for WC, 0.490 for WHtR, and 3.179 for BRI; those in men were 24.64 kg/m² for BMI, 87.25 cm for WC, 0.510 for WHtR, and 3.547 for BRI. The AUC values and cut-off points of the indices were also analyzed in each age and BMI category.

CONCLUSIONS

In Chinese adults, WHtR and BRI showed a superior predictive power for MetS in both sexes, which can be used as simple and effective screening tools for cardiometabolic risks and MetS in clinical practice.

Anthropometrics, Metabolic Syndrome, and Mortality Hazard

Independent indices (height, body mass index, a body shape index, and hip index) derived from basic anthropometrics have been found to be powerful predictors of mortality hazard, especially when the attributable risks are summed over these indices to give an anthropometric risk index (ARI). The metabolic syndrome (MS) is defined based on the co-occurrence of anthropometric, clinical, and laboratory criteria and is also widely employed for evaluating disease risk. Here, we investigate correlations between ARI and MS in a general population sample, the United States Third National Health and Nutrition Examination Survey. Baseline values of ARI and MS were also evaluated for their association with mortality over approximately 20 years of follow-up. ARI was found to be positively correlated with each component of MS, suggesting connections between the two entities as measures of cardiometabolic risk. ARI and MS were both significant predictors of mortality hazard. Although the association of ARI with mortality hazard was stronger than that of MS, a combined model with both ARI and MS score as predictors improved predictive ability over either construct in isolation. We conclude that the combination of anthropometrics and clinical and laboratory measurements holds the potential to increase the effectiveness of risk assessment compared to using either anthropometrics or the current components of MS alone.

Association of Body Shape Index (ABSI) with cardio-metabolic risk factors: A cross-sectional study of 6081 Caucasian adults

A Body Shape Index (ABSI) was specifically developed as a transformation of waist circumference (WC), statistically independent of BMI to better evaluate the relative contribution of WC to central obesity and clinical outcomes. Previous studies have found ABSI is associated with total mortality and cardiovascular events. However, no study has specifically evaluated the joint contribution of ABSI and BMI to cardio-metabolic outcomes (high triglycerides, low HDL, high fasting glucose and high blood pressure). With this aim, we performed a retrospective study on 6081 Caucasian adults. Subjects underwent a medical interview, anthropometric measurements, blood sampling, measurement of blood pressure, and measurement of visceral abdominal fat thickness (VAT) by ultrasound. Generalized linear models (GLM) were used to evaluate the sex and age adjusted association of ABSI with binary and continuous cardio-metabolic risk factors. Four pre-specified GLM were evaluated for each outcome: M1 = ABSI, BMI and ABSI*BMI interaction, M2 = ABSI and BMI, M3 = ABSI alone and M4 = BMI alone. Bayesian Information Criterion (BIC) was calculated and used to identify the best predictive model. ABSI and BMI contributed independently to all outcomes. Compared to BMI alone, the joint use of BMI and ABSI yielded significantly improved associations for having high triglycerides (BIC = 5261 vs. 5286), low HDL (BIC = 5371 vs. 5381), high fasting glucose (BIC = 6328 vs. 6337) but not high blood pressure (BIC = 6580 vs. 6580). The joint use of BMI and ABSI was also more strongly associated with VAT than BMI alone (BIC = 22930 vs. 23479). In conclusion, ABSI is a useful index for evaluating the independent contribution of WC, in addition to that of BMI, as a surrogate for central obesity on cardio-metabolic risk.

Comparison of the ability to identify arterial stiffness between two new anthropometric indices and classical obesity indices in Chinese adults

BACKGROUND AND AIMS

The association between anthropometric indices of body composition and arterial stiffness is inconclusive. The objective of this study was to examine the predictive ability of two new obesity indices: a body shape index (ABSI), and a body roundness index (BRI), for the identification of arterial stiffness among Chinese adults, as well as to compare the relative strength of association between the anthropometric indices and arterial stiffness.

METHODS

A total of 10,197 subjects were recruited in this cross-sectional study. We tested the association between anthropometric indices (body mass index [BMI], waist circumference [WC], waist-height-ratio [WHtR], ABSI and BRI) and brachial-ankle pulse wave velocity (PWV). Receiver operating characteristic curve and area under curve (AUC) were employed to evaluate the predictive value of the anthropometric indices for identification of arterial stiffness.

RESULTS

After adjusting for confounding variables, BRI (linear regression: 0.112; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.173 for male) exhibited a more powerful predictive ability of arterial stiffness than ABSI (linear regression: 0.110; AUC: 0.674; OR: 1.315 for female and linear regression: 0.058; AUC: 0.610; OR: 1.150 for male) and WC (linear regression: 0.078; AUC: 0.699; logistic regression: negative for female and linear regression: negative; AUC: 0.593; logistic regression: negative for male) while having a similar predictive value to that of WHtR (linear regression: 0.113; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.185 for male) among both sexes. BMI (linear and logistic regression: negative; AUC: 0.660 for female and 0.568 for male) had the lowest predictive power in both sex categories. The optimal cut-off of WHtR for detecting arterial stiffness was 0.49 in females and 0.53 in males, that of BRI was 3.19 in females and 3.89 in males.

CONCLUSIONS

WHtR, ABSI and BRI were significantly associated with arterial stiffness. BRI and WHtR, rather than ABSI, showed superior predictive abilities for arterial stiffness in both sexes.

Comparison between body mass index and a body shape index with adiponectin/leptin ratio and markers of glucose metabolism among adolescents

BACKGROUND

Besides body mass index (BMI), new parameters have been developed to classify individual body shape.

AIM

To investigate the relationship between BMI, waist circumference (WC), a body shape index (ABSI) and ABSI-adolescents among adolescents and verify which would better predict lower adiponectin/leptin (A/L) ratio and disturbances on glucose metabolism.

SUBJECTS AND METHODS

A cross-sectional study with 197 Brazilian adolescents of 14-18 years. Serum leptin, adiponectin, glucose and insulin were measured. A/L ratio, ABSI, ABSI-adolescents, BMI, homeostasis model assessment estimates of insulin resistance (HOMA-IR) and β-cell function (HOMA-β) and the quantitative insulin sensitivity check index (QUICKI) were calculated.

RESULTS

ABSI-adolescents positively correlated with WC (r = 0.83, p < 0.0001) and BMI (r = 0.66, p < 0.0001), but stronger correlations were observed between WC and BMI (r = 0.95, p < 0.0001). ABSI-adolescents, BMI and WC negatively correlated with A/L ratio (all p < 0.0001). The correlation between BMI and A/L ratio was the strongest (r = -0.63, p < 0.001). A/L ratio, BMI, WC and ABSI-adolescents correlated with markers of glucose metabolism (all p < 0.0001) and the strongest correlation was observed with BMI (QUICKI: r = -0.75; HOMA-IR: r = 0.76; HOMA-β: r = 0.77; insulin: r = 0.79). Associations were confirmed by linear regression analysis, adjusted for sex and age.

CONCLUSIONS

ABSI-adolescents, but not ABSI, was related to A/L ratio and to markers of glucose metabolism, but not more strongly than BMI and WC.

Body shape index: Sex-specific differences in predictive power for all-cause mortality in the Japanese population

Background

While body mass index (BMI) is the most widely used anthropometric measure, its association with all-cause mortality is generally J-shaped or U-shaped. A body shape index (ABSI) is a recently formulated anthropometric measure that shows linear relationship to all-cause mortality, especially in Caucasian cohorts. We aimed to address the relationship between ABSI and all-cause mortality in Asians and to assess the influence of sex difference and of chronic kidney disease (CKD) on this relationship.

Methods

This was a longitudinal cohort study assessing the association of ABSI, BMI, waist circumference (WC), and waist-to-height ratio (WHtR) with all-cause mortality in a Japanese nationwide Specific Health Checkup database. The study enrolled 160,625 participants followed-up between 2008 and 2012. We calculated the all-cause mortality risk associated with a 1-standard deviation increase (+1SD) in ABSI, BMI, WC, or WHtR in cohorts stratified by sex and the presence of CKD.

Results

During the 4-year follow up, 1.3% of participants died. In men, ABSI (+1SD) significantly increased the risk for all-cause mortality after adjusting for other known risk factors including CKD; hazard ratio (HR) and 95% confidence intervals (CI) of non-CKD cohort, 1.30 (1.18 to 1.43), p<0.01; HR and 95%CI of CKD cohort, 1.16 (1.01 to 1.34), p = 0.04. In women, ABSI (+1SD) did not show significant association with all-cause mortality, especially in the CKD cohort; HR and 95% CI of non-CKD cohort, 1.07 (0.99 to 1.17), p = 0.09; HR and 95%CI of CKD cohort, 0.98 (0.84 to 1.14), p = 0.78. Conversely, BMI (+1SD) was associated with significantly lower risk in men, although minimal association was found in women. WC and WHtR showed little association with all-cause mortality. On stratification per ABSI quartiles, mortality risk increased linearly and significantly with ABSI in men, but not in women with CKD. Both BMI and WC showed significant but U-shaped association with mortality in the non-CKD cohort and in men with CKD. WHtR also showed significant U-shaped association with mortality in men.

Conclusions

In the Japanese population, ABSI showed significant and linear correlation with mortality risk in men but not in women, especially in the presence of CKD.

Comparison of anthropometric measurements associated with the risk of endoscopic erosive esophagitis: A cross-sectional study

BACKGROUND

In this cross-sectional study, we assessed five anthropometric measurements to determine the most reliable indicator of the erosive esophagitis (EE) risk: body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI).

METHODS

This study included 182,407 participants who underwent an esophagogastroduodenoscopy as part of a routine health check-up. We used the area under the receiver-operating characteristic curve (AUC) to assess the discriminatory power of each anthropometric measure as an indicator of EE risk.

RESULTS

The prevalence of EE increased per quartile for all five anthropometric measurements in patients of both sexes (1st quartile vs. 4th quartile, all P<0.05). ABSI had the lowest AUCs for EE in both sexes (AUC: 0.524, 95% CI: 0.519-0.529 for male patients; AUC: 0.524, 95% CI: 0.513-0.535 for female patients). In contrast, BRI was the best predictor of EE in male patients (OR: 2.095, 95% CI: 1.982-2.215, P<0.0001), and WC was the best predictor of EE in female patients (OR: 2.028, 95% CI: 1.785-2.307, P<0.0001). WC showed the highest AUC values for EE in both male patients (AUC: 0.571, 95% CI: 0.566-0.576) and female patients (AUC: 0.596, 95% CI: 0.585-0.608).

CONCLUSIONS

BRI and WC were the most relevant indicators of EE risk in male and female patients, respectively. ABSI was the least reliable indicator of EE risk in patients of both sexes.

Anthropometric discriminators of type 2 diabetes among White and Black American adults

BACKGROUND

The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample.

METHODS

We used Atherosclerosis Risk in Communities study baseline data (1987-89) from 15 242 participants (1827 with T2DM) aged 45-65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist:  height ratio (WHtR), and waist:  hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models.

RESULTS

Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race-gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults.

CONCLUSIONS

Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race-gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females.