The Association between Z-Score of Log-Transformed A Body Shape Index and Cardiovascular Disease in Korea

Association between body shape index and risk of mortality in the United States

The body mass index (BMI) neither differentiates fat from lean mass nor does it consider adipose tissue distribution. In contrast, the recently introduced z-score of the log-transformed A Body Shape Index (LBSIZ) can be applied to measure obesity using waist circumference (WC), height, and weight. We aimed to investigate the association between LBSIZ and mortality. We used data from the National Health and Nutrition Examination Survey 1999–2014 and linked the primary dataset to death certificate data from the National Death Index with mortality follow-up through December 31, 2015. A multiple Cox regression analysis was performed to evaluate the hazard ratio (HR) of all-cause and cardiovascular disease (CVD) mortalities with adjustment for baseline characteristics. LBSIZ, WC, and BMI showed positive association with total fat percentage (P < 0.001); however, only WC and BMI were positively associated with appendicular skeletal mass index (ASMI) (P < 0.001). In the multiple Cox regression analysis, only LBSIZ showed a significant HR for all-cause and CVD mortalities. Under restricted cubic spline regression, mortality risk increased with LBSIZ. However, BMI and WC showed a U-shape association. In conclusion, LBSIZ is strongly associated with all-cause and CVD mortalities. Since LBSIZ is independent of BMI, LBSIZ complements BMI to identify high-risk groups for mortality even in individuals with low or normal BMI.

Body Shape Index and Cardiovascular Risk in Individuals With Obesity

Introduction: Cardio-metabolic risks are tested to show various anthropometric measurements. This study aimed to evaluate a body shape index (ABSI) of individuals with obesity to determine the role of these measurements in cardiovascular risk prediction.

Methods: This cross-sectional study included 368 patients who were evaluated by the researcher in the polyclinic. Sociodemographic information was obtained, and anthropometric measurements were made. Body mass index (BMI), waist circumference, and ABSI were evaluated in all patients. The patient’s risk of developing cardiovascular disease was calculated from the pooled cohort equations risk calculator (PRCAE), Framingham risk score, and systematic coronary risk evaluation (SCORE) risk calculation systems.

Results: Of the 368 patients in the study, 302 (82.1%) were females, and 66 (17.9%) were males. The average age of participants was 46.2 ± 12.0 years. The median BMI of participants was 37.5 (34.0-42.4) kg/m². The median ABSI of participants was 0.0816 (0.0775-0.0849). A positive correlation was found between ABSI and Framingham risk score and PRCAE risk score (r = 0.297, p = 0.000 and r = 0.305, p = 0.000, respectively). A significant relationship was found between ABSI and Framingham, PRCAE, and SCORE risk groups (p = 0.000, p = 0.000, and p = 0.000, respectively).

Conclusions: Our study results revealed a significant association of ABSI with Framingham, PRCAE, and SCORE risk calculation systems, which helps predict cardiovascular risk.

Utility of the Z-score of log-transformed A Body Shape Index (LBSIZ) in the assessment for sarcopenic obesity and cardiovascular disease risk in the United States

Body mass index (BMI) has limited accuracy for predicting cardiovascular diseases (CVD) and is not capable of identifying sarcopenic obesity, the combination of sarcopenia (an age-associated decline in muscle mass and physical function) and obesity. To overcome this, the z-score of the log-transformed A Body Shape Index (LBSIZ) was recently introduced as a measure of obesity using waist circumference, height, and weight. We aimed to investigate the association of LBSIZ with sarcopenic obesity and CVD, and propose appropriate cut-off values using the National Health and Nutrition Examination Survey 1999–2016 data. Of 92,062 participants, 40,468 adults (≥20 years) were included. Overall area under curve (AUC) of LBSIZ was 0.735 (95% confidence interval [CI]: 0.716–0.754) for sarcopenic obesity, and 0.695 (95% CI: 0.687–0.703) for CVD. The subgroup analysis of ethnicity/race showed similar results. Waist circumference (WC), BMI, conicity index, body roundness index (BRI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), new BMI, and waist to height ratio (WHtR) showed a negative association with sarcopenic obesity, while LBSIZ and conicity index showed a positive association. The AUC of LBSIZ was significantly higher for sarcopenic obesity than that of conicity index (p < 0.001). The AUC of LBSIZ was significantly higher for CVD than those of parameters including WC, BMI, BRI, CUN-BAE, new BMI, and WHtR (p < 0.001). The AUC for conicity index alone was comparable to that of LBSIZ for CVD. Overall LBSIZ cut-off was 0.35 for both sarcopenic obesity (sensitivity, 65.3%; specificity, 71.5%) and CVD (sensitivity, 63.3%; specificity, 66.6%). These results may be useful not only to identify sarcopenic obesity, but also to conduct CVD risk assessment in the clinical setting.