Article

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: 5.39). 04/2006; 30(3):475-83. DOI: 10.1038/sj.ijo.0803144
Source: PubMed

ABSTRACT 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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    • "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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    • "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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