The Usefulness of Anthropometric Indices to Identify the Risk of Metabolic Syndrome

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Abstract

Despite several papers having been published on the association between adiposity and the risk of metabolic syndrome (MetS), it is still difficult to determine unambiguously which of the indices of nutritional status is the best to identify MetS. The aim of this study was to analyze the ability of six anthropometric indices to identify MetS in the Polish population. The highest odds ratios for the occurrence of MetS, according to International Diabetes Federation (IDF), were noted for the following indices: waist-to-height ratio (WHtR, OR = 24.87) and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE, OR = 17.47) in men and WHtR (OR = 25.61) and body roundness index (BRI, OR = 16.44) in women. The highest odds ratios for the modified definition of MetS (without waist circumference) were found for the following indices: WHtR (OR = 7.32), BRI (OR = 6.57), and CUN-BAE (OR = 6.12) in women and CUN-BAE (OR = 5.83), WHtR (OR = 5.70), and body mass index (BMI, OR = 5.65) in men ( p < 0.001 for all). According to the Receiver Operating Characteristic (ROC) analyses conducted for the identification of MetS, defined in accordance with IDF, the largest areas under the curve (AUCs) in men were observed for WHtR and CUN-BAE indices, whereas in women, they were observed for WHtR and BRI. In the analysis carried out for the identification of MetS (according to modified definition, without waist circumference), the AUCs were larger for WHtR and BRI in women, while in men, they were larger for CUN-BAE, BMI, and WHtR. BMI was also characterized by a relatively strong discriminatory power in identifying individuals with MetS. An optimal cut-off point for MetS, in accordance with the conventional definition, for both sexes was the value of BMI = 27.2 kg/m ². The weakest predictor of the syndrome was the ABSI (a body shape index) indicator. The most useful anthropometric indicator for the identification of MetS, both in men and in women in the Polish population, was WHtR. The optimal cut-off points for WHtR equaled 0.56 in men and 0.54 in women.

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A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index

Nir Krakauer, Jesse C. Krakauer (2012)

Background Obesity, typically quantified in terms of Body Mass Index (BMI) exceeding threshold values, is considered a leading cause of premature death worldwide. For given body size (BMI), it is recognized that risk is also affected by body shape, particularly as a marker of abdominal fat deposits. Waist circumference (WC) is used as a risk indicator supplementary to BMI, but the high correlation of WC with BMI makes it hard to isolate the added value of WC. Methods and Findings We considered a USA population sample of 14,105 non-pregnant adults ( ) from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 with follow-up for mortality averaging 5 yr (828 deaths). We developed A Body Shape Index (ABSI) based on WC adjusted for height and weight: ABSI had little correlation with height, weight, or BMI. Death rates increased approximately exponentially with above average baseline ABSI (overall regression coefficient of per standard deviation of ABSI [95% confidence interval: – ]), whereas elevated death rates were found for both high and low values of BMI and WC. ( – ) of the population mortality hazard was attributable to high ABSI, compared to ( – ) for BMI and ( – ) for WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up. Conclusions Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements. ABSI expresses the excess risk from high WC in a convenient form that is complementary to BMI and to other known risk factors.

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Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity

John T Wilkins, Sadiya S Khan, Donald M. Lloyd-Jones … (2018)

This population-based study calculates lifetime risk estimates for incident cardiovascular disease and subtypes of cardiovascular disease and estimates years lived with and without cardiovascular disease by weight status. Question What is the association of body mass index with cardiovascular disease (CVD) morbidity and mortality? Findings In this population-based study, overweight and obesity were associated with significantly increased risk for CVD. Obesity was associated with shorter longevity and a greater proportion of life lived with CVD; overweight was associated with similar longevity as normal weight but at the expense of a greater proportion of life lived with CVD. Meaning These results provide critical perspective on CVD associated with overweight and obesity and challenge both the obesity paradox as well as the view that overweight is associated with greater longevity. Importance Prior studies have demonstrated lower all-cause mortality in individuals who are overweight compared with those with normal body mass index (BMI), but whether this may come at the cost of greater burden of cardiovascular disease (CVD) is unknown. Objective To calculate lifetime risk estimates of incident CVD and subtypes of CVD and to estimate years lived with and without CVD by weight status. Design, Setting, and Participants In this population-based study, we used pooled individual-level data from adults (baseline age, 20-39, 40-59, and 60-79 years) across 10 large US prospective cohorts, with 3.2 million person-years of follow-up from 1964 to 2015. All participants were free of clinical CVD at baseline with available BMI index and CVD outcomes data. Data were analyzed from October 2016 to July 2017. Exposures World Health Organization–standardized BMI categories. Main Outcomes and Measures Total CVD and CVD subtype, including fatal and nonfatal coronary heart disease, stroke, congestive heart failure, and other CVD deaths. Heights and weights were measured directly by investigators in each study, and BMI was calculated as weight in kilograms divided by height in meters squared. We performed (1) modified Kaplan-Meier analysis to estimate lifetime risks, (2) adjusted competing Cox models to estimate joint cumulative risks for CVD or noncardiovascular death, and (3) the Irwin restricted mean to estimate years lived free of and with CVD. Results Of the 190 672 in-person examinations included in this study, the mean (SD) age was 46.0 (15.0) years for men and 58.7 (12.9) years for women, and 140 835 patients (73.9%) were female. Compared with individuals with a normal BMI (defined as a BMI of 18.5 to 24.9), lifetime risks for incident CVD were higher in middle-aged adults in the overweight and obese groups. Compared with normal weight, among middle-aged men and women, competing hazard ratios for incident CVD were 1.21 (95% CI, 1.14-1.28) and 1.32 (95% CI, 1.24-1.40), respectively, for overweight (BMI, 25.0-29.9), 1.67 (95% CI, 1.55-1.79) and 1.85 (95% CI, 1.72-1.99) for obesity (BMI, 30.0-39.9), and 3.14 (95% CI, 2.48-3.97) and 2.53 (95% CI, 2.20-2.91) for morbid obesity (BMI, ≥40.0). Higher BMI had the strongest association with incident heart failure among CVD subtypes. Average years lived with CVD were longer for middle-aged adults in the overweight and obese groups compared with adults in the normal BMI group. Similar patterns were observed in younger and older adults. Conclusions and Relevance In this study, obesity was associated with shorter longevity and significantly increased risk of cardiovascular morbidity and mortality compared with normal BMI. Despite similar longevity compared with normal BMI, overweight was associated with significantly increased risk of developing CVD at an earlier age, resulting in a greater proportion of life lived with CVD morbidity.

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European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care

Dominique Durrer Schutz, Luca Busetto, Dror Dicker … (2019)

The first contact for patients with obesity for any medical treatment or other issues is generally with General Practitioners (GPs). Therefore, given the complexity of the disease, continuing GPs’ education on obesity management is essential. This article aims to provide obesity management guidelines specifically tailored to GPs, favouring a practical patient-centred approach. The focus is on GP communication and motivational interviewing as well as on therapeutic patient education. The new guidelines highlight the importance of avoiding stigmatization, something frequently seen in different health care settings. In addition, managing the psychological aspects of the disease, such as improving self-esteem, body image and quality of life must not be neglected. Finally, the report considers that achieving maximum weight loss in the shortest possible time is not the key to successful treatment. It suggests that 5–10% weight loss is sufficient to obtain substantial health benefits from decreasing comorbidities. Reducing waist circumference should be considered even more important than weight loss per se , as it is linked to a decrease in visceral fat and associated cardiometabolic risks. Finally, preventing weight regain is the cornerstone of lifelong treatment, for any weight loss techniques used (behavioural or pharmaceutical treatments or bariatric surgery).

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Journal

Journal ID (nlm-ta): Nutrients

Journal ID (iso-abbrev): Nutrients

Journal ID (publisher-id): nutrients

Title: Nutrients

Publisher: MDPI

ISSN (Electronic): 2072-6643

Publication date (Electronic): 29 October 2019

Publication date Collection: November 2019

Volume: 11

Issue: 11

Electronic Location Identifier: 2598

Affiliations

[1 ]The Institute of Health Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland; eciesla@ 123456ujk.edu.pl (E.C.); mgluszekosuch@ 123456ujk.edu.pl (M.G.-O.); dorota.koziel@ 123456ujk.edu.pl (D.K.)

[2 ]The Institute of Medical Sciences, Medical College, Jan Kochanowski University, ul. Zeromskiego 5, 25-369 Kielce, Poland; tomrogula@ 123456gmail.com (T.R.); sgluszek@ 123456wp.pl (S.G.)

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[* ]Correspondence: edyta.suliga@ 123456ujk.edu.pl ; Tel.: +48-41-349-69-09; Fax: +48-41-349-69-16

Author information

Edyta Suliga https://orcid.org/0000-0003-3063-0380

Stanisław Głuszek https://orcid.org/0000-0001-7752-0459

Dorota Kozieł https://orcid.org/0000-0001-8114-1814

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Publisher ID: nutrients-11-02598

DOI: 10.3390/nu11112598

PMC ID: 6893758

PubMed ID: 31671800

SO-VID: 8cde40eb-8762-4c33-a1e8-089da3db47df

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

The Usefulness of Anthropometric Indices to Identify the Risk of Metabolic Syndrome

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Karger: Nutrition and Dietetics

Most cited references 30

A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index

Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity

European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care

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