Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors

Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts Universität zu Kiel, Kiel, Germany.
International Journal of Obesity (Impact Factor: 5). 04/2006; 30(3):475-83. DOI: 10.1038/sj.ijo.0803144
Source: PubMed


To compare the value of body fat mass (%FM) to indirect measures of general (body mass index (BMI)) and central adiposity (waist circumference (WC); waist-to-height ratio (WC/ht)) for the prediction of overweight- and obesity-related metabolic risk in a study population with a high prevalence of metabolic syndrome (MSX).
BMI, WC, WC/ht, body composition (by air-displacement plethysmography) and metabolic risk factors: triglycerides, cholesterol, HDL-cholesterol (HDL-C), uric acid, systolic blood pressure (BPsys), insulin resistance by homeostasis model assessment (HOMA-IR) and C-reactive protein (CRP) were measured in 335 adults (191 women, 144 men; mean age 53 +/-13.9 years, prevalence of MSX 30%).
When compared with BMI and WC, %FM showed weaker associations with metabolic risk factors, except for CRP and BPsys in men. In women, HDL-C and HOMA-IR showed the closest correlations with BMI. For all other risk factors, WC or WC/ht were the best predictors in both sexes. Differences in the strength of correlations between an obesity index and different risk factors exceeded the differences observed between all obesity indices within one risk factor. In stepwise multiple regression analyses, WC/ht was the main predictor of metabolic risk in both sexes combined. However, analysis of the area under receiver operating characteristic curves for prediction of the prevalence of >or=2 component traits of the MSX revealed a similar accuracy of all obesity indices.
At the population level, measurement of body FM has no advantage over BMI and WC in the prediction of obesity-related metabolic risk. Although measures of central adiposity (WC, WC/ht) tended to show closer associations with risk factors than measures of general adiposity, the differences were small and depended on the type of risk factor and sex, suggesting an equivalent value of methods.

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Available from: Simone Onur, Mar 11, 2014
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    • "Although WC is highly correlated with abdominal visceral fat, it is also correlated with total and subcutaneous fat depot [40]. Moreover, WHtR and BMI were more correlated with each other compared with percent of body fat [41]. Therefore, BMI and WHtR as indices of general and central obesity would have some limitations. "
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    ABSTRACT: Several studies have concluded a positive association between abdominal obesity, general obesity, and chronic diseases. However, the best anthropometric measures to predict the risk for chronic diseases should be clarified in each population. Therefore, the aim of this study was to compare the predictive power of A Body Shape Index (ABSI), body mass index (BMI), and waist-to-height ratio and Clinica Universidad de Navarra-Body Adiposity Estimator for metabolic syndrome (MetS) and cardiovascular disease (CVD) risks among Iranians in different age and sex categories. This population-based cross-sectional study conducted on 9555 individuals, ages ≥19 y. Anthropometric measures, blood pressure, and biochemical markers were measured using standard protocols. Hypertension, hyperglycemia, hypercholesterolemia, high low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol levels were considered as the CVD risks. Mean (SD) of age and BMI of participants were 38.7 y (mean 15.5) and 25.7 kg/m(2) (mean 4.6), respectively. ABSI demonstrated the weakest correlations and lowest area under curve (AUC) for various risk factors and MetS. However, the highest odds ratio was observed for ABSI and MetS in different age and sex categories. Based on the AUC, we concluded that ABSI is a weak predictor for CVD risks and MetS. More studies are needed to determine the best predictor of CVD risk among the Iranian population.
    Nutrition 06/2014; 30(6):636-44. DOI:10.1016/j.nut.2013.10.021 · 2.93 Impact Factor
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    • "The waist-to-height ratio was first used in the Framingham Study [14]. Several studies of children [15] and adults [16] have concluded that this ratio is more strongly associated with cardio vascular risk factors than the body mass index (BMI; in kg/m2). In a population-based study from Hong Kong, this ratio has been most strongly associated with cardiovascular risk with a suggested cutoff value of 0.5 for Asian population [17]. "
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    ABSTRACT: To determine whether waist-to-height ratio correlates with coronary artery disease (CAD) severity better, than the body mass index (BMI) as assessed by coronary angiography in Bangladeshi population. This cross sectional study was done on patients in Department of Cardiology in DMCH and those referred in the cath-lab of the Department of Cardiology for CAG during November 2009 to October 2010 involving 120 patients. They were divided into group-A (with coronary score >=7) and group-B (coronary score <7) depending on Gensisni score.Result: There were no statistically significant difference regarding the distribution of age, sex and clinical diagnosis and parameters between the two groups. The mean age of patients was 51.7 +/- 8.2 years and 48.8 +/- 9.1 years in Group A and Group B respectively with a male predominance in both the groups. Patients in group A had higher BMI >=25 and waist to height ratio (>=0.55) than Group B which showed a statistically significant association (p < 0.001). Though a significant positive correlation (r = 0.296, p = 0.006) was observed between BMI and Coronary artery disease score in group A patients, scenario was reverse fro group B (r = 0.076, p = 0.659). The statement was also true for Waist-to-height ratio and Waist-to-height ratio with BMI. Multivariate analysis also yeilded that a patient with BMI >=25 kg/m2 and waist-to height ratio of >=0.55 are 3.06 times and 6.77 times, more likely to develop significant coronary artery disease respectively. The waist-to-height ratio showed better correlation with the severity of coronary artery disease than the BMI.
    BMC Research Notes 04/2014; 7(1):246. DOI:10.1186/1756-0500-7-246
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    • "Waist circumference (WC) is an adiposity measure that, if properly adjusted by some power of height [2], can add predictive ability of childhood body weight to adult blood pressure [4] [5]. Several recent studies have found that waist-to-height ratio (WHtR) is better than WC at predicting obesity, overweight [6], cardiovascular risk factors [7] and mortality [8], is better than BMI at predicting hypertension, diabetes, dyslipidemia [9], metabolic syndrome [10] and its risk factors [11], type II diabetes [12] and cardiovascular risk factors [7], and is better than waist-to-hip ratio (WHR) at predicting cardiovascular risk factors [7] and mortality[8]. WHtR also has the added benefit of not requiring adjustment for age or sex [13], though that may still be done. "
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    ABSTRACT: Objectives: While researchers are increasingly recognizing the importance of adjusting waist circumference (WC) for height, no standard has yet been established. In this study we contrast three standard methods for indexing WC by height (using height, root-height and height-squared) via comparisons with age-specific optimal indices. Study design and setting: Measurements from 722 male and 746 female Caucasian participants in the Fels Longitudinal Study were used. The three standard waist-circumference indices (as well as an optimal index) were determined for ages 2 through 18, and for every decade thereafter to 70 years of age. Pearson correlations were used to assess the suitability of all indices. Results: The three standard indices remain correlated with the original WC measures, though each was associated with height at some ages. Waist-to-height ratio is suitable for some childhood ages (boys: 5 - 9, 13 - 16; girls: 4 - 7, 9, 11 - 14) but not for adult ages; Root-height works well mostly for older teenage children and adults but not in early childhood and adolescence; Height-squared is nowhere suitable. In both men and women, the optimal indexing factor ranged between root-height and height-squared in childhood, and is close to root-height in adulthood. Conclusions: No one index is most suitable, as WC indexed by root-height is suitable for use with measurements from teenage children and adults, while waist-to-height ratio is generally suitable for use in children. WC indexed by height-squared is nowhere suitable.
    Open Journal of Endocrine and Metabolic Diseases 08/2012; 2(3):40-48. DOI:10.4236/ojemd.2012.23006
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