A Body Shape Index (ABSI) as a Variant of Conicity Index Not Affected by the Obesity Paradox: A Cross-Sectional Study Using Arterial Stiffness Parameter

Association of a Body Shape Index with Bone Mineral Density and Osteoporosis Among U.S. Adults: Evidence from NHANES

Obesity significantly impacts bone health. The ABSI is an innovative metric for assessing obesity, offering greater accuracy than traditional measures such as body mass index and waist circumference in reflecting visceral fat accumulation. This study aims to investigate the relationship between ABSI and BMD as well as its association with osteoporosis among U.S. adults, utilizing data from the NHANES. This cross-sectional study analyzed data from adults aged 18 years and older, collected during the 2005-2006, 2013-2014, and 2017-2018 cycles of the NHANES. Multivariate linear regression models were used to evaluate the association between ABSI and BMD. Multivariate logistic regression models were applied to assess the relationship between ABSI and osteoporosis. Restricted cubic spline models were employed to evaluate potential nonlinear associations between ABSI and BMD as well as osteoporosis. Additionally, subgroup analyses and sensitivity analyses were conducted to ensure the robustness of the findings. A total of 5487 participants were included in the analysis, with a mean age of 47.04 years. ABSI was found to be negatively associated with BMD at the femoral neck, total femur, and lumbar spine. Participants in the highest ABSI quartile exhibited a significantly higher prevalence of osteoporosis compared to those in the lowest quartile (OR = 1.95; 95% CI 1.61-2.26). Nonlinear relationships were observed between ABSI and BMD at the femoral neck, total femur, lumbar spine, and osteoporosis, with inflection points at 8.84, 8.56, 9.23, and 8.14, respectively. Sensitivity analyses confirmed the robustness of these associations. Subgroup analyses revealed significant interactions between ABSI and BMD in smokers (P < 0.05). This study identifies a significant negative association between ABSI and BMD and a positive association with osteoporosis. The nonlinear relationship observed between ABSI and both BMD and osteoporosis underscores the importance of maintaining an optimal ABSI to promote bone health. These findings support the utility of ABSI as a valuable marker for early identification and prevention of osteoporosis, offering actionable insights for clinical and public health strategies. Future longitudinal research is warranted to validate these results and further elucidate the underlying mechanisms.

The best anthropometric indices to predict colon cancer

BACKGROUND

Colon cancer is one of the most prevalent malignancies globally. Anthropometric data are widely accessible. However, numerous anthropometric indicators exist, and no study has identified the most reliable predictor for colon cancer. This study aims to identify the most effective anthropometric indicators for predicting colon cancer.

RESULTS

Significant differences were observed in age, race, smoking, diabetes, hypertension, waist circumference, a body shape index (ABSI), Body Roundness Index (BRI), Conicity Index (ConI), Waist-to-Height Ratio(WHtR), and Weight-adjusted Waist Index(WWI) between colon cancer patients and controls (P < 0.05). ABSI (AUC: 0.68, 95% CI: 0.64-0.71), ConI (AUC: 0.68, 95% CI: 0.64-0.71), and WWI (AUC: 0.67, 95% CI: 0.63-0.70) were the most accurate anthropometric indices for predicting colon cancer. ABSI, ConI, and WWI demonstrated a strong correlation.

CONCLUSION

Analysis of NHANES data (2005-2018) identified ABSI, ConI, and WWI (AUC:0.67-0.68) as optimal anthropometric predictors of colon cancer, emphasizing abdominal obesity's clinical relevance. These cost-effective indices could enhance early screening in resource-limited settings.

Association between body shape index and arterial stiffness: results of the EVasCu study and a meta-analysis

OBJECTIVE

The aim of this study was to analyse the association between body shape index (ABSI) and arterial stiffness in healthy subjects using data from the EVasCu study. In addition, a meta-analysis was performed to compare the association between ABSI and central, peripheral and systemic arterial stiffness in the general population.

METHODS

The EVasCu study included 390 healthy subjects. ABSI was calculated from waist circumference, body mass index and height, and arterial stiffness was assessed with aortic pulse wave velocity (a-PWv) and cardio-ankle vascular index (CAVI). A meta-analysis of previous studies, including data from the EVasCu study, was performed to obtain pooled estimates of correlation coefficients (r) and their respective 95% confidence intervals (95% CIs) for the association between ABSI and central, peripheral and systemic arterial stiffness. In addition, pooled OR estimates and their 95% CIs were calculated.

RESULTS

In the EVasCu study, the correlation coefficient estimate was 0.458 (p < 0.01) for the association of a-PWv and ABSI and 0.408 (p < 0.01) for the association of CAVI and ABSI. In the meta-analysis, the pooled correlation coefficient estimate was 0.22 (95% CIs: 0.16, 0.28) for central arterial stiffness and ABSI, 0.21 (95% CIs: 0.14, 0.28) for peripheral arterial stiffness and ABSI, and 0.28 (95% CI: 0.21, 0.3) for systemic arterial stiffness and ABSI. When pooled ORs were calculated, the pooled OR estimate was 2.12 (95% CIs: 1.68, 2.56) for central arterial stiffness and ABSI, 2.21 (95% CIs: 1.81, 2.60) for peripheral arterial stiffness and ABSI, and 2.99 (95% CIs: 2.14, 3.85) for systemic arterial stiffness and ABSI.

CONCLUSION

Based on both the results obtained in the EVasCu study and the meta-analysis, there is a positive association between ABSI and arterial stiffness, both in healthy subjects and in participants with comorbidities. For each unit of cm/kg/m²/m increase in ABSI, the risk of arterial stiffness increased by 112% for central arterial stiffness, 121% for peripheral arterial stiffness, and 199% for systemic arterial stiffness. However, further research is needed in this field of knowledge.

Association between anthropometric indices and chronic kidney disease: Insights from NHANES 2009-2018

INTRODUCTION

The strong association between obesity and chronic kidney disease (CKD) has been empirically validated, yet traditional measures like the Body Mass Index (BMI) fail to accurately assess the extent of obesity due to CKD's characteristics, such as reduced muscle mass and increased visceral fat. This study investigates the association between CKD and several anthropometric indices, including A Body Shape Index (ABSI), Body Roundness Index (BRI), Waist-to-Height Ratio (WHtR), and the Conicity Index (C-index), to determine their predictive capabilities.

METHODS

Based on the datasets from the National Health and Nutrition Examination Survey (NHANES) 2009-2018, weighted multivariable regression analyses were carried out to examine the independent relationship between two anthropometric indices and CKD. Also, subgroup analyses, restricted cubic spline regression (RCS), and receiver operating characteristic curve analysis were conducted for further data analyses.

RESULTS

A total of 24,162 participants were enrolled in this study. After adjusting for confounding factors, ABSI, BRI, WHtR, and the C-index were significantly associated with an increased risk of CKD, while BMI was not. Height showed a protective effect against CKD. ABSI and the C-index demonstrated the highest areas under the curve (AUCs), indicating superior predictive capabilities compared to traditional measures like BMI and waist circumference (WC). Subgroup analyses revealed significant interactions between the anthropometric indices and factors such as age, disease status, dietary intake, and physical activity levels.

CONCLUSIONS

This study highlights the significant associations between various anthropometric indices (including ABSI, BRI, WHtR, and C-index) and the risk of CKD. ABSI and the C-index demonstrated the strongest predictive capabilities for CKD, with the highest AUC values.

The synergistic effect of the triglyceride-glucose index and a body shape index on cardiovascular mortality: the construction of a novel cardiovascular risk marker

BACKGROUND

Insulin resistance, represented by increased triglyceride-glucose (TyG) index levels, shows interplay with visceral obesity and together promotes cardiovascular diseases and mortality. However, significant controversies exist regarding whether modified TyG indices, such as TyG-BMI, TyG-WC, and TyG-WHtR, outperform the TyG index in predicting cardiovascular outcomes. We aimed to explore whether there was a synergistic effect of a body shape index (ABSI), a better parameter reflecting visceral obesity, and the TyG index on cardiovascular mortality.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2001-2018 of 17,329 individuals. The associations of the TyG index and ABSI with cardiovascular mortality were investigated via Cox regression analysis and restricted cubic splines. Receiver operating characteristic (ROC) curve analysis was performed to compare the predictive value. Mediation analysis was used to explore the potential mediator.

RESULTS

A total of 673 (3.9%) cardiovascular deaths occurred during a median follow-up of 8.92 years. Individuals with high TyG and high ABSI (TyG > 9.04 and ABSI > 0.085) were at the highest cardiovascular mortality risk both in individuals with (HR = 1.714, 95% CI 1.123-2.616) and without diabetes (HR = 1.402, 95% CI 1.003-1.960), suggesting a synergistic effect. Next, we multiplied these two indicators and established TyG-ABSI. It showed a J-shaped relationship and a positive linear relationship with cardiovascular mortality in individuals with and without diabetes, respectively. Arterial stiffness, represented by estimated pulse wave velocity, partially mediated the effect of TyG-ABSI on cardiovascular mortality, with a mediation proportion of 42.7%. The predictive value of TyG-ABSI was greater than that of the TyG index, TyG-BMI, TyG-WC, and TyG-WHtR (Harrell's C-index: 0.710 vs 0.623 vs 0.539 vs 0.612 vs 0.622, all p < 0.001).

CONCLUSIONS

The simultaneous assessment of the TyG index and ABSI revealed a synergistic effect on cardiovascular mortality. We recommended the use of TyG-ABSI instead of the TyG index and other modified TyG indices in cardiovascular risk assessment.

A Body Shape Index as a Simple Anthropometric Marker for the Risk of Cardiovascular Events

PURPOSE OF REVIEW

To provide an overview of the predictive value of A Body Shape Index (ABSI) for the risk of cardiovascular events.

RECENT FINDINGS

ABSI has been reported to have an association with development of cardiovascular diseases, and its usefulness for predicting major cardiovascular events including cardiovascular mortality, nonfatal coronary syndrome and nonfatal stroke has been investigated. The formula for ABSI includes waist circumference, which is not included in the conventional calculation of body mass index (BMI), along with BMI and height. High ABSI is independently associated with a high incidence of cardiovascular events. ABSI with specific cutoff values can be a useful tool for cardiovascular risk stratification by detecting the presence of abdominal obesity and it can be used for evaluation of the risk of cardiovascular events. Nonetheless, other factors such as race, gender, age, and physical, environmental and socioeconomic purviews also need be taken into consideration.

Age-Related Arterial Stiffening Is Associated with a Body Shape Index and Lean Body Mass Index: A Retrospective Cohort Study in Healthy Japanese Population

INTRODUCTION

Several anthropometric indices reflecting cardiometabolic risks have been developed, but the relationship of body composition with arterial stiffness remains unclear. We aimed to determine the interaction between age-related anthropometric changes and progression of arterial stiffness.

METHODS

This research analyzed cross-sectional data (N = 13,672) and 4-year longitudinal data (N = 5,118) obtained from a healthy Japanese population without metabolic disorders. The relationship of age with anthropometric indices comprising estimated lean body mass index (eLBMI), body mass index (BMI), waist circumference (WC), and a body shape index (ABSI) was examined. The mediating effects of the indices on the association between age and arterial stiffness assessed by cardio-ankle vascular index (CAVI) were analyzed.

RESULTS

Unlike BMI and WC, ABSI (Rs = 0.284) and CAVI (Rs = 0.733) showed a positive linear relationship with aging in stratified analyses. Especially in the middle-older age groups, eLBMI showed a declining trend with aging. An increase in ABSI was associated with a decrease in eLBMI, whereas increase in BMI or WC was related to increased eLBMI. In cross-sectional analyses, age was associated with CAVI, partially mediated by ABSI or eLBMI after adjusting confounders. Baseline CAVI correlated negatively with 4-year change in (Δ)eLBMI (Rs = -0.120 in men, -0.161 in women). ΔCAVI correlated negatively with ΔeLBMI (Rs = -0.031).

CONCLUSION

ABSI is a modifiable index that well reflects age-related changes in arterial stiffness and body composition including lean body mass. Since arterial stiffening may cause skeletal muscle loss, potentially creating a vicious cycle, prioritizing CAVI and anthropometric indices in clinical practice may be a useful strategy.

The association between a body shape index and depressive symptoms: a cross-sectional study using NHANES data (2011-2018)

Objective

This study aimed to explore the relationship between A Body Shape Index (ABSI) and depressive symptoms, and to evaluate the moderating effects of sociodemographic, lifestyle, and health factors.

Methods

We analyzed data from 19,659 participants in the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). ABSI was calculated from waist circumference, height, and BMI. Multiple linear regression models were employed to investigate the association between ABSI and depressive symptoms, with subgroup analyses to examine potential associations within specific populations.

Results

Higher ABSI was significantly associated with increased depressive symptoms, after adjusting for covariates including age, sex, race, marital status, poverty-income ratio, smoking, alcohol consumption, physical activity, diabetes, and hypertension. Individuals in the highest ABSI quartile (Q4) had significantly more depressive symptoms compared to those in the lowest quartile (Q1) (β = 0.22, 95% CI = 0.02-0.41, p = 0.0323). Subgroup analyses revealed that marital status and hypertension significantly moderated the association between ABSI and depressive symptoms.

Conclusion

This study provides the first comprehensive analysis of the link between ABSI and depressive symptoms, suggesting that higher ABSI is associated with greater depressive symptoms. These findings highlight the potential importance of waist circumference and abdominal fat distribution in assessing depression risk. Future research should explore the causal mechanisms underlying this association and investigate the biological pathways involved, to inform more effective strategies for depression prevention and intervention.

Predictive Diagnostic Power of Anthropometric Indicators for Metabolic Syndrome: A Comparative Study in Korean Adults

Background/Objectives: Metabolic syndrome (MetS) is a cluster of risk factors that significantly increase the risk of cardiovascular disease, including type 2 diabetes, etc. Assessing the predictive diagnostic power of anthropometric indicators for MetS is crucial for the early identification and prevention of related health issues. This study focuses on the Korean adult population while providing insights that may be applicable to broader global contexts. Therefore, this study aimed to compare the predictive diagnostic capabilities of various anthropometric indicators, including body mass index (BMI), waist-to-height ratio (WHtR), muscle mass-to-fat mass ratio (MFR), muscle mass-to-waist ratio (MWR), and body shape index (ABSI), in relation to MetS in Korean adults. Methods: Data from 13,725 participants of the Korea National Health and Nutrition Examination Survey (2008-2011) were analyzed. The diagnostic power of each indicator was assessed using the receiver operating characteristic (ROC) curve analysis, and the area under the curve (AUC) values were compared. Participants were classified into normal (NG) and abnormal (AG) groups based on established cutoff values, and logistic regression analysis was performed to evaluate the odds of MetS in each group. Results: WHtR showed the highest AUC values (0.792 for men and 0.768 for women), indicating superior diagnostic accuracy compared to the other indicators (p < 0.001). Logistic regression analysis indicated that both the unadjusted and adjusted odds ratios (OR) for MetS were significantly higher in the AG than in the NG across all indicators (p < 0.001). Specifically, the adjusted OR (95% confidence interval) for WHtR in the AG was 6.793 (5.929-7.784) for men and 4.665 (4.151-5.423) for women, representing the highest values among all indicators (p < 0.001). Conclusion: Among the various anthropometric indicators, WHtR is the most reliable and practical for predicting MetS in Korean adults. It is useful for early intervention and prevention in both clinical and public health settings.

Joint association of triglyceride glucose index (TyG) and a body shape index (ABSI) with stroke incidence: a nationwide prospective cohort study

BACKGROUND

Triglyceride glucose index(TyG) and a body shape index(ABSI) are both independent predictor of stroke incidence or adverse prognosis but these two indicators seldom were combined to predict. The purpose of this study is to evaluate whether the combination of TyG and ABSI better predict the incidence of stroke.

METHODS

Based on the China Health and Retirement Longitudinal Study(CHARLS), 8,257 people aged 45 years and older without stroke were enrolled and followed up to 9 years. Sociodemographic information, health status, physical examination and blood data were collected retrospectively. Cox regressions were to determine the relationship between different groups and stroke incidence, using receiver operating characteristic curves to evaluate the diagnostic value. Meanwhile, subgroup analysis was performed to investigate the prediction performance among different population.

RESULTS

672(8.14%) of 8,257 participants had stroke incidence during 9 years. In the adjusted multivariate cox regression model, both TyG and ABSI were still predictors of stroke. The HR of TyG was 1.25(95%CI: 1.06-1.47) and the HR of ABSI was 1.33(95%CI: 1.06-1.68). Restricted cubic spline regression showed the associations between TyG or ABSI and stroke. The combination of TyG and ABSI had the highest diagnostic efficacy(AUC: 0.579, 95%CI: 0.553-0.597), compared to TyG(AUC:0.566, 95%CI: 0.544-0.587) and ABSI(AUC:0.533, 95%CI: 0.524-0.597). Kaplan-Meier curves showed that the highest cumulative stroke incidence was among people with high TyG and ABSI(TyG ≥ 8.5742, ABSI ≥ 0.0852; P < 0.0001), which had the highest HR of stroke incidence(HR:1.64, 95%CI:1.2-2.24).

CONCLUSION

The combined prediction of TyG and ABSI had higher clinical value and enabled earlier detection of the stroke in the general population, which could be monitored and intervened to reduce the overall burden of stroke.

Association of "a body shape index" with the risk of developing colorectal cancer in U.S. patients with metabolic syndrome: evidence from the NHANES 1999-2018

BACKGROUND

Colorectal cancer (CRC) is the third most common cancer worldwide and presents a significant challenge to public health. Metabolic syndrome (MetS) is a condition that is predominantly characterized by abdominal obesity and metabolic abnormalities such as hypertension, hyperglycemia, and hyperlipidemia, and it is one of the critical risk factors for CRC. Traditional anthropometric measures have limitations in accurately assessing the risk associated with abdominal obesity. This study aimed to investigate the association between "A Body Shape Index" (ABSI) and the risk of developing CRC among individuals with MetS utilizing data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

This cross-sectional study conducted a statistical analysis of all adult participants who met the diagnostic criteria for MetS in the NHANES data from 1999 to 2018. The ABSI was calculated to quantify abdominal obesity. ABSI is derived from a formula that incorporates waist circumference (WC), body mass index (BMI), and height, and is calculated as ABSI = WC / (BMI^(2/3) × Height^(1/2)). Multivariate logistic regression modeling was used to examine the independent association between ABSI and CRC incidence. Receiver Operating Characteristic (ROC) curves were employed to analyze the ability of ABSI compared to traditional metrics in identifying CRC risk.

RESULTS

This study involved 16,018 MetS patients with a mean age of 51.8 years, of whom 50.3% were male and 49.7% were female. Logistic regression adjusted for confounders revealed a significant association between an elevated ABSI and an increased risk of developing CRC (odds ratio (OR): 1.433, 95% confidence interval (CI): 1.116 to 1.841; P = 0.005). ROC analyses confirmed that the predictive accuracy of the ABSI for the risk of developing CRC area under the curve (AUC): (0.668, 95% CI: 0.624 to 0.713) surpassed that of traditional measurement methods.

CONCLUSION

Among individuals with MetS, the ABSI is linked to an elevated risk of developing CRC. Compared with traditional anthropometric indices, the ABSI is a superior predictive marker for the risk of developing CRC.

Association of weight-adjusted waist index (WWI) and a body shape index (ABSI) with serum neurofilament light chain levels in a national study of U.S. adults

OBJECTIVE

This study explored how the weight-adjusted waist index (WWI) and a body shape index (ABSI) are related to serum neurofilament light chain (sNfL) levels among U.S. adults. We aimed to evaluate sNfL, which plays key roles in neuronal injury in neurological diseases, given its understudied connection to obesity.

METHODS

We used cross-sectional data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) of people with complete information on the weight-adjusted waist index (WWI), a body shape index (ABSI), and serum neurofilament light chain (sNfL). Multiple linear regression analysis allowed us to investigate the separate connections among the WWI, ABSI, and sNfL. Moreover, interaction testing and subgroup analysis were performed to improve the general validity of our results. To assess any nonlinear correlations, we also performed threshold effect analysis and smoothed curve fitting.

RESULTS

WWI and ABSI were positively linked with sNfL (WWI: β = 0.05, 95% CI 0.01-0.09; ABSI: β = 1.65, 95% CI 3.53-13.72). There was no clear reliance on this association according to subgroup analysis and interaction tests. Smoothed curve fitting and saturation effects also demonstrated nonlinear associations between WWI and ABSI and sNfL, with inflection points of 10.38 and 0.38, respectively.

CONCLUSION

In the adult American population, while the WWI and ABSI are linearly positively correlated with serum neurofilament light protein (sNfL), the effect size is greater for the ABSI. This correlation provides fresh evidence connecting obesity to neurological conditions, deepening our comprehension of the extensive health impacts associated with obesity. Level of Evidence Level I, experimental studies.

A Body Shape Index as a Simple Anthropometric Marker of Abdominal Obesity and Risk of Cardiovascular Events

CONTEXT

A Body Shape Index (ABSI) has been reported to have associations with cardiovascular risk factors. However, there is no information on the association between ABSI and incidence of cardiovascular events.

METHODS

We investigated the associations between ABSI and first major cardiovascular events (death from cardiovascular disease, nonfatal acute coronary syndrome, and nonfatal stroke) in 1857 subjects from the database of Flow-Mediated Dilation Japan registry and from Hiroshima University Vascular Function registry.

RESULTS

The areas under the curves of ABSI to predict the first major cardiovascular events were superior to BMI (men: P = .032, women: P = .015) and waist circumference in women (men: P = .078, women: P = .002). The subjects were divided into 2 groups based on the cutoff value of ABSI for predicting first major cardiovascular events: a low ABSI group (<0.0822 in men and <0.0814 in women) and a high ABSI group (≥0.0822 in men and ≥0.0814 in women). During a median follow-up period of 41.6 months, 56 subjects died (23 from cardiovascular causes), 16 had nonfatal acute coronary syndrome, and 14 had nonfatal stroke. The Kaplan-Meier curves for first major cardiovascular events were significantly different between the 2 groups (men, P < .001; women, P < .001). Multivariate analysis revealed that high ABSI remained an independent predictor of first major cardiovascular events (men: hazard ratio, 2.33; 95% CI, 1.07 to 5.06; P = .033; women: hazard ratio, 8.33; 95% CI, 1.06 to 65.49; P = .044).

CONCLUSION

High ABSI is independently associated with incidence of cardiovascular events. ABSI calculation should be performed for evaluation of risk of cardiovascular events.

Visceral Fat-Reducing Effect of Novel Dietary Intervention Program: A Randomized Controlled Trial in Japanese Males

Background/Objectives: Reducing visceral fat is a critical factor in preventing obesity-related health complications. In this study, we evaluated the effectiveness of our previously reported novel dietary intervention program, "Optimized Nutri-Dense Meals", designed according to the Dietary Reference Intakes (DRIs) in Japan in reducing visceral fat. Method: This open-label, randomized controlled trial included 100 Japanese males with obesity or overweight. In total, 50 participants were assigned to a control group that continued their usual diets, and the other 50 consumed test meals twice per week for four weeks (test group). Result: The primary outcome, visceral fat area, significantly decreased in the test group compared to that in the control group (-7.5 cm2, confidence interval [CI]: -14.3 to -0.6). In addition, we measured the changes in gut flora and work productivity. The abundance of Bifidobacterium (+1.5%, CI: 0.3-2.7) and Christensenellaceae (+0.4%, CI: 0.01-0.8) increased significantly in the test group compared with those in the control group. Work Limitation Questionnaire Japanese version scores representing presenteeism also significantly increased in the test group (+1.2 points, CI: 0.2-2.3) compared with the control group. Conclusions: These findings suggest that dietary interventions based on Japanese DRIs can effectively decrease visceral fat and improve health outcomes over the short term without the need for a complete dietary overhaul.

Relationship between Body Adiposity Indices and Reversal of Metabolically Unhealthy Obesity 6 Months after Roux-en-Y Gastric Bypass

The factors determining the reversal of metabolically unhealthy obesity (MUO) to metabolically healthy obesity (MHO) after Roux-en-Y gastric bypass (RYGB) are not completely elucidated. The present study aims to evaluate body adiposity and distribution, through different indices, according to metabolic phenotypes before and 6 months after RYGB, and the relationship between these indices and transition from MUO to MHO. This study reports a prospective longitudinal study on adults with obesity who were evaluated before (T0) and 6 months (T1) after RYGB. Bodyweight, height, waist circumference (WC), BMI, waist-to-height ratio (WHR), total cholesterol (TC), HDL-c, LDL-c, triglycerides, insulin, glucose, HbA1c and HOMA-IR were evaluated. The visceral adiposity index (VAI), the conicity index (CI), the lipid accumulation product (LAP), CUN-BAE and body shape index (ABSI) were calculated. MUO was classified based on insulin resistance. MUO at T0 with transition to MHO at T1 formed the MHO-t group MHO and MUO at both T0 and T1 formed the MHO-m and MUO-m groups, respectively. At T0, 37.3% of the 62 individuals were classified as MHO and 62.7% as MUO. Individuals in the MUO-T0 group had higher blood glucose, HbA1c, HOMA-IR, insulin, TC and LDL-c compared to those in the MHO-T0 group. Both groups showed significant improvement in biochemical and body variables at T1. After RYGB, 89.2% of MUO-T0 became MHO (MHO-t). The MUO-m group presented higher HOMA-IR, insulin and VAI, compared to the MHO-m and MHO-t groups. CI and ABSI at T0 correlated with HOMA-IR at T1 in the MHO-t and MHO-m groups. CI and ABSI, indicators of visceral fat, are promising for predicting post-RYGB metabolic improvement. Additional studies are needed to confirm the sustainability of MUO reversion and its relationship with these indices.

Optimal cut-off points of anthropometric and body roundness indices associated with diabetes: Persian (Shahedieh) cohort study

Introduction

Diabetes is a chronic and concerning health condition that poses a significant public health challenge. Given that preventing, detecting early, and treating T2DM can enhance public health outcomes, the objective of this study was to identify the most effective obesity indices and determine their optimal cut-off points for predicting the risk of T2DM in an Iranian population.

Methods

This study was conducted on 8,019 male and female participants aged between 35 and 70 years in the context of Shahedieh cohort study. The ROC curve analysis was utilized to determine the optimal cut-off point of each anthropometric index to predict diabetes in age-sex categories.

Results

The overall diabetes incidence in the study population was 2.5%, with 2.5% in men and 2.4% in women. In men, significant differences in most of the anthropometric indices were observed between diabetic individuals and healthy counterparts. This study found that for women 45-65, BMI and weight, and for men under 65 years, weight, WHR, BMI, WC, WHTR, AVI, and BRI are efficient T2DM predictors. The AUC of these indices varied from 0.593 (95% CI: 0.510-0.676) to 0.668 (95% CI: 0.586-0.750) in men, and from 0.587 (95% CI: 0.510-0.664) to 0.644 (95% CI: 0.535-0.754) in women.

Conclusion

Anthropometric indices and body roundness are simple, inexpensive, and noninvasive means markers to predict the risk of diabetes. Our findings show that most of the studied indices had acceptable prediction power for men except for elderly. For women over 45 years old, weight and BMI are appropriate predictors. It seems that the approach of reducing diabetes incidence through early detection and primary prevention is achievable.

Association of a body shape index with femur bone mineral density among older adults: NHANES 2007-2018

This study investigated the relationship between A body shape index (ABSI) and bone mineral density (BMD) in older Americans and found a negative linear association, which was particularly pronounced in diabetic population. An early focus on ABSI in the elderly population will help in the prevention of osteoporosis.

OBJECTIVE

A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and high ABSI indicates that waist circumference (WC) is higher than expected for a given height and weight and corresponds to a more central concentration of body volume. The objective of this study was to determine whether there is a linear or nonlinear relationship between ABSI and total femur bone mineral density (BMD) in older Americans and whether the relationship between the ABSI and total femur BMD varies across populations.

METHODS

This cross-sectional study was based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multiple linear regression, restricted cubic spline (RCS) curves, subgroup analysis, and interaction tests were used to examine the association between ABSI and total femur BMD.

RESULTS

This study included 2505 older adults. This study found a negative linear correlation between ABSI and total femur BMD (β = -3.2, 95%CI: -5.0, -1.4, p < 0.001). When participants were grouped according to quartiles of ABSI, those in the upper quartile had lower total femur BMD compared to those in the bottom quartile of ABSI. This negative association remained consistent across gender, age, education level, smoking, physical activity and BMI subgroups. However, in the diabetes subgroup, ABSI showed a stronger negative association with total femur BMD.

CONCLUSIONS

The study shows a negative linear association between ABSI and total femur BMD in older Americans, with this negative association being stronger in the diabetic population.

Relation between waist circumference and the renal hemodynamic in healthy individuals

BACKGROUND AND AIMS

Obesity has been shown to be an independent risk factor for the development of CKD. Little is known about pathways of interaction of visceral fat mass estimated by waist circumference (WC) and metabolic factors with the renal and intraglomerular hemodynamic profile in healthy, non-obese individuals.

METHODS AND RESULTS

The study population of this post-hoc analysis in 80 healthy individuals, who participated in a randomized, controlled clinical trial (www.

CLINICALTRIALS

gov: NCT02783456) was divided into two groups based on median of WC (high WC and low WC group). Renal hemodynamic profiles were analyzed using steady state input clearance (infusion of para-amino-hippuric acid and inulin). Intraglomerular pressure (IGP) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated (Gomez equation). The analysis included healthy, non-smoking individuals, aged 27 ± 9 years with median WC of 84.75 ± 9 cm. Glomerular filtration rate (GFR) (110 ± 15 vs. 127 ± 16 ml/min/m2, p < 0.001), renal plasma flow (RPF) (620 ± 109 vs. 700 ± 104 ml/min, p = 0.001) and IGP (36.7 ± 2.3 vs. 38.5 ± 3.1 mmHg, p = 0.003) were lower in the high WC compared to the low WC group. Patients in the high WC group showed higher renal vascular resistance (RVR) (85 ± 19 vs. 70 ± 12 mmHg/(ml/min), p < 0.001), higher RA (4034 ± 1177 vs. 3069 ± 786 dyn∗s/cm5, p < 0.001) and higher RE (2283 ± 339 vs. 2118 ± 280 dyn∗s/cm5, p = 0.021) compared to the low WC group. Individuals in the high WC group showed higher leptin levels (p = 0.003) and higher HOMA-IR (p = 0.024) compared to the low WC group.

CONCLUSION

Increased WC in healthy young individuals was associated with reduced GFR and RPF likely mediated by increased RVR.

Selecting, optimizing and externally validating a preexisting machine-learning regression algorithm for estimating waist circumference

Obesity, typically defined by the body mass index (BMI), has well known negative health effects. However, the BMI has serious deficiencies in predicting the adverse risks associated to obesity. Waist circumference (WC) is an alternative to define obesity and a better disease predictor according to the literature. However, old databases often lack this information, it is inaccurate (collected via self-report) or it is incomplete. Thus, this study accurately assesses WC using machine learning. The novel approaches are: 1) predictor variables (weight, height, age and sex) likely to appear in most data sets are used. 2) Publicly available data (including non-adults) and algorithms are used. 3) Systematic methods for data cleanup, model selection, hyperparameter optimization and external validation are performed. DATA ARE CLEANED: one variable per column, no special codes, missing values or outliers. Preexisting regression algorithms are gaged by cross-validation, using one data set. The hyperparameters of the best performing algorithm are optimized. The tuned algorithm is externally validated with other data sets by cross-validation. In spite of the limited number of features, the tuned algorithm outperforms prior WC approximations, using the same or similar predictor variables. The tuned algorithm enables using data where WC is not measured, is incomplete or is unreliable. A similar approach would be useful to estimate other variables of interest.

Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study

AIM

To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness.

METHODS

Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0.

RESULTS

Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks.

CONCLUSION

Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.

Role of Machine Learning-Based CT Body Composition in Risk Prediction and Prognostication: Current State and Future Directions

CT body composition analysis has been shown to play an important role in predicting health and has the potential to improve patient outcomes if implemented clinically. Recent advances in artificial intelligence and machine learning have led to high speed and accuracy for extracting body composition metrics from CT scans. These may inform preoperative interventions and guide treatment planning. This review aims to discuss the clinical applications of CT body composition in clinical practice, as it moves towards widespread clinical implementation.

Functionally Significant Variants in Genes Associated with Abdominal Obesity: A Review

The high prevalence of obesity and of its associated diseases is a major problem worldwide. Genetic predisposition and the influence of environmental factors contribute to the development of obesity. Changes in the structure and functional activity of genes encoding adipocytokines are involved in the predisposition to weight gain and obesity. In this review, variants in genes associated with adipocyte function are examined, as are variants in genes associated with metabolic aberrations and the accompanying disorders in visceral obesity.