Body adiposity index and all-cause and cardiovascular disease mortality in men

Development of Data Mining Algorithms for Identifying the Best Anthropometric Predictors for Cardiovascular Disease: MASHAD Cohort Study

INTRODUCTION

Many studies have been published to assess the best anthropometric measurements associated with cardiovascular diseases (CVDs), but controversies still exist.

AIM

Investigating the association between CVDs and anthropometric measurements among Iranian adults.

METHODS

For a total population of 9354 aged 35 to 65, a prospective study was designed. Anthropometric measurements including ABSI (A Body Shape Index), Body Adiposity Index (BAI), Body Mass Index (BMI), Waist to Height Ratio (WHtR), Body Round Index (BRI), HC (Hip Circumference), Demispan, Mid-arm circumference (MAC), Waist-to-hip (WH) and Waist Circumference (WC) were completed. The association between these parameters and CVDs were assessed through logistic regression (LR) and decision tree (DT) models.

RESULTS

During the 6-year follow-up, 4596 individuals (49%) developed CVDs. According to the LR, age, BAI, BMI, Demispan, and BRI, in male and age, WC, BMI, and BAI in female had a significant association with CVDs (p-value < 0.03). Age and BRI for male and age and BMI for female represent the most appropriate estimates for CVDs (OR: 1.07, (95% CI: 1.06, 1.08), 1.36 (1.22, 1.51), 1.14 (1.13, 1.15), and 1.05 (1.02, 1.07), respectively). In the DT for male, those with BRI ≥ 3.87, age ≥ 46 years, and BMI ≥ 35.97 had the highest risk to develop CVDs (90%). Also, in the DT for female, those with age ≥ 54 years and WC ≥ 84 had the highest risk to develop CVDs (71%).

CONCLUSION

BRI and age in male and age and BMI in female had the greatest association with CVDs. Also, BRI and BMI was the strongest indices for this prediction.

A Cardiovascular Disease Prediction Model Based on Routine Physical Examination Indicators Using Machine Learning Methods: A Cohort Study

Background

Cardiovascular diseases (CVD) are currently the leading cause of premature death worldwide. Model-based early detection of high-risk populations for CVD is the key to CVD prevention. Thus, this research aimed to use machine learning (ML) algorithms to establish a CVD prediction model based on routine physical examination indicators suitable for the Xinjiang rural population.

Method

The research cohort data collection was divided into two stages. The first stage involved a baseline survey from 2010 to 2012, with follow-up ending in December 2017. The second-phase baseline survey was conducted from September to December 2016, and follow-up ended in August 2021. A total of 12,692 participants (10,407 Uyghur and 2,285 Kazak) were included in the study. Screening predictors and establishing variable subsets were based on least absolute shrinkage and selection operator (Lasso) regression, logistic regression forward partial likelihood estimation (FLR), random forest (RF) feature importance, and RF variable importance. The selected subset of variables was compared with L1 regularized logistic regression (L1-LR), RF, support vector machine (SVM), and AdaBoost algorithm to establish a CVD prediction model suitable for this population. The incidence of CVD in this population was then analyzed.

Result

After 4.94 years of follow-up, a total of 1,176 people were diagnosed with CVD (cumulative incidence: 9.27%). In the comparison of discrimination and calibration, the prediction performance of the subset of variables selected based on FLR was better than that of other models. Combining the results of discrimination, calibration, and clinical validity, the prediction model based on L1-LR had the best prediction performance. Age, systolic blood pressure, low-density lipoprotein-L/high-density lipoproteins-C, triglyceride blood glucose index, body mass index, and body adiposity index were all important predictors of the onset of CVD in the Xinjiang rural population.

Conclusion

In the Xinjiang rural population, the prediction model based on L1-LR had the best prediction performance.

Cardiovascular Disease Prediction by Machine Learning Algorithms Based on Cytokines in Kazakhs of China

Background

Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Accurately identifying subjects at high-risk of CVD may improve CVD outcomes. We sought to systematically examine the feasibility and performance of 7 widely used machine learning (ML) algorithms in predicting CVD risks.

Methods

The final analysis included 1508 Kazakh subjects in China without CVD at baseline who completed follow-up. All subjects were randomly divided into the training set (80%) and the test set (20%). L1-penalized logistic regression (LR), support vector machine with radial basis function (SVM), decision tree (DT), random forest (RF), k-nearest neighbors (KNN), Gaussian naive Bayes (NB), and extreme gradient boosting (XGB) were employed for prediction CVD outcomes. Ten-fold cross-validation was used during model developing and hyperparameters tuning in the training set. Model performance was evaluated in the test set in light of discrimination, calibration, and clinical usefulness. RF was applied to obtain the variable importance of included variables. Twenty-two variables, including sociodemographic characteristics, medical history, cytokines, and synthetic indices, were used for model development.

Results

Among 1508 subjects, 203 were diagnosed with CVD over a median follow-up of 5.17 years. All 7 models had moderate to excellent discrimination (AUC ranged from 0.770 to 0.872) and were well calibrated. LR and SVM performed identically with an AUC of 0.872 (95% CI: 0.829–0.907) and 0.868 (95% CI: 0.825–0.904), respectively. LR had the lowest Brier score (0.078) and the highest sensitivity (97.1%). Decision curve analysis indicated that SVM was slightly better than LR. The inflammatory cytokines, such as hs-CRP and IL-6, were identified as strong predictors of CVD.

Conclusion

SVM and LR can be applied to guide clinical decision-making in the Kazakh Chinese population, and further study is required to ensure their accuracies.

Body roundness index is a superior indicator to associate with the cardio-metabolic risk: evidence from a cross-sectional study with 17,000 Eastern-China adults

Background

To investigate the ability of body shape index (ABSI), body roundness index (BRI), waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body adiposity index (BAI) for predicting non-adipose cardio-metabolic risk.

Methods

A total of 17,360 Chinese subjects aged 18–95 years old who escaped cardiovascular disease (CVD) or diabetes were recruited in the cross-sectional study. Anthropometric and biochemical parameters were assessed. Receiver operating characteristic curve (ROC) and multinomial logistic regression were conducted to examine the association of anthropometric indicators with cardio-metabolic risk factors.

Results

The mean age of subjects were 53.7(13.1) years, 41.6 % were males. The areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to predict high cardio-metabolic risk (AUC > 0.70). Meanwhile, multinomial logistic regression showed BRI was significantly associated with high cardio-metabolic risk (OR 3.27, 95% CI 3.01–3.55). The optimal cut-off values of BRI for high cardio-metabolic risk were (< 60 y: 3.49 vs. ≥60 y: 3.46) in males and (< 60 y: 3.47 vs. ≥60 y: 3.60) in females.

Conclusions

WC, BMI WHR, and WHtR were potential obesity indicators in discriminating high cardio-metabolic risk, while BAI or ABSI was not. Moreover, BRI revealed superior predictive capacity and significant association with accumulated cardio-metabolic risk factors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-021-01905-x.

The Impact of Educational Intervention Based on Theory of Planned Behavior for Promoting Physical Activity Among Middle-Aged Women Referring to Karaj (Iran) Health Centers

BACKGROUND

Physical activity is the most critical determinant of physical health which reduces the health risks during life. This designed study aims to evaluate the effect of educational intervention based on the theory of planned behavior on promoting physical activity among middle-aged women attending the health centers in Karaj city during 2017-2018.

METHODS

This research was a quasi-experimental controlled trial, and the study incorporated 140 Middle-Aged Women Referring to Karaj Health Centers assigned randomly to a control and intervention group (70 each group). Participants enrolling in the survey were asked to complete the International Physical Activity Questionnaire and also the theory of planned behavior measures at the baseline and the end of the study. The SPSS software were used, to analyze the data. The study applied Nonparametric Wilcoxon and Mann-Whitney tests and ANCOVA to interpret the results.

RESULTS

The results revealed participants' age range between 30 to 50 years with the mean and standard deviation scores 40.07 (8.750) in training and 45.81 (8.513) at the control group. The intervention improved the theory of planned behavior measures and the physical activities of participants. The results showed a significant difference in the attitude score, the perceived behavioral control score, and the level of subjective norms between two training and non-training groups (P < 0.001). The followed-up physical activity score also showed an improvement in the IPAQ score of participants in the training group (p < 0.001).

CONCLUSIONS

The results of this specific study support the effectiveness of the theory of planned behavior for promoting the physical activity of women.

Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies

OBJECTIVE

To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included.

DATA SYNTHESIS

A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves.

RESULTS

Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index.

CONCLUSIONS

Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.

Association between body adiposity index and coronary risk in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

BACKGROUND & AIMS

The body adiposity index (BAI) was recently proposed as a better indicator of body adiposity than body mass index in adults. The association between BAI and cardiometabolic risk factors has been widely investigated. However, the strength and magnitude of these associations varied as a function of the endpoint evaluated, the study design, the population investigated, and the cut-off points used. The aim of this study was to investigate the association between BAI and coronary heart disease (CHD) risk in a large sample of Brazilian adults and to propose the most appropriate cut-off points for BAI for the identification of CHD risk in the adult Brazilian population.

METHODS

Data from 15,092 civil servants (54.4% women) from universities and research institutes in six Brazilian states were evaluated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). All were aged 35-74 years at baseline. The Framingham coronary risk score was used to identify a very high risk of CHD (≥20% risk of CHD over the next 10 years) and a high risk of CHD (≥10% risk). BAI cut-off points capable of detecting a risk of CHD were determined using ROC curves and associations were tested using Poisson regression with robust variance, according to sex and age. Three multivariable models were examined.

RESULTS

BAI remained positively associated with a very high and high risk of CHD following adjustment for potential confounding factors in all the strata and multivariable models (p < 0.05), with the exception of model 3 (adjusted for education level and waist-to-hip ratio) for very a high risk of CHD in younger women (p = 0.06). In the adjusted models, the prevalence ratios for a very high and high risk of CHD, irrespective of age group, varied between 1.23 (95%CI: 1.09-1.39) and 1.64 (1.33-2.03) and 1.07 (1.03-1.12) and 1.47 (1.36-1.60) in men; and 1.57 (1.08-2.31) and 2.42 (1.36-4.31) and 1.29 (1.13-1.47) and 1.82 (1.54-2.15) in women, respectively. The optimal cut-off points of BAI to determine a risk of CHD were: 28.0 in men of both age groups, and 34.0 in younger women and 36.0 in older women to determine a very high risk; and 26.0 in younger men and 34.0 in women of both age groups to determine a high risk. BAI showed a reasonable ability to predict coronary risk in participants of the ELSA-Brasil (AUC>60%, except for the group of men of 60-74 years of age).

CONCLUSIONS

Higher BAI levels were found to be associated with a greater risk of developing CHD in both men and women of different ages participating in the ELSA-Brasil, suggesting that BAI may be a useful tool for screening for CHD risk in Brazilian adults.

New indexes of body fat distribution and sex-specific risk of total and cause-specific mortality: a prospective cohort study

Background

A number of prior studies have examined the association between anthropometric measures and mortality, but studies investigating the sex-specific predictive value of novel anthropometric measures on mortality are scarce so far. Therefore, we investigated the sex-specific relevance of the new anthropometric measures body adiposity index (BAI) and waist to height ratio (WHtR) as well as the common measures body mass index (BMI), waist circumference (WC), and waist to hip ratio (WHR) for cause-specific mortality risk.

Methods

The analysis was based on data from the German population based KORA (Cooperative Health Research in the Region of Augsburg) Augsburg cohort study. A total of 6670 men and 6637 women aged 25 to 74 years at baseline examination were included. During a mean follow-up period of 15.4 years, 2409 persons died. Via Cox proportional hazard regression, the associations between the different anthropometric measures and all cause-, cardiovascular disease (CVD)- and cancer mortality were assessed.

Results

BMI, WC, and WHR were significantly associated with all-cause and CVD-mortality in both sexes. WC and WHR were particularly associated with higher all-cause and CVD-mortality risk in women, while in men especially WHtR and BAI were strongly related to these outcomes. Females with WC, WHtR, and WHR measures in the 4th quartile compared with women in the 2nd quartile had a higher risk of death from cancer. Contrary, men in the lowest quartile of WC and WHtR in comparison to men in the 2nd quartile had a significantly elevated cancer mortality risk. BAI was no risk predictor for all-cause and cause-specific mortality in women.

Conclusions

Central obesity reflects higher all-cause and CVD-mortality risk particularly in women. BAI and WHtR seem to be valid as risk predictors for all-cause and especially CVD mortality in men but not women. There are marked sex-differences regarding cancer mortality risk for the different anthropometric measures.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5350-8) contains supplementary material, which is available to authorized users.

Adiposity cut-off points for cardiovascular disease and diabetes risk in the Portuguese population: The PORMETS study

Objectives

The contribution of adiposity to cardiovascular and diabetes risk justifies the inclusion of an adiposity measure, usually waist circumference, in the definition of metabolic syndrome. However, waist circumference thresholds differ across populations. Our aim was to assess which adiposity measure performs the best in identifying the metabolic syndrome in a sample of Portuguese participants and to estimate cut-off values for these measures.

Methods

Data were obtained from a cross-sectional study (PORMETS study) conducted in Portugal between 2007 and 2009. A representative sample of non-institutionalized adults, comprising 3,956 participants, aged 18 years and older, was evaluated. A structured questionnaire was administered, collecting information on personal medical history, socio-demographics and behavioral characteristics. Anthropometrics, blood pressure and venous blood samples were also obtained. Metabolic syndrome was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology recommended criteria. Elevated cardiometabolic risk was considered when two or more of the four criteria of metabolic syndrome were present, excluding the waist circumference component. A receiver operating characteristic curve was used to estimate cut-off points.

Results

This study found that waist-to-height ratio, waist circumference and body adiposity index performed better than other adiposity measures, such as body mass index. The estimated cut-off points for waist-to-height ratio, waist circumference and body adiposity index in women and men were 0.564 / 89 cm / 27.4 and 0.571 / 93.5 cm / 25.5, respectively.

Conclusion

As waist circumference is currently used as the adiposity measure in the definition of metabolic syndrome and as no relevant differences were observed between this measure and waist-to-height ratio, it is likely that no modification to the metabolic syndrome definition needs to be proposed. Moreover, this study also confirmed the applicability of European cut-off points in the Portuguese population.

Anthropometric Indicators of Adiposity Related to Body Weight and Body Shape as Cardiometabolic Risk Predictors in British Young Adults: Superiority of Waist-to-Height Ratio

Frequently reported poor dietary habits of young adults increase their risk of metabolic syndrome (MetS). Excess adiposity is the most established predictor of MetS, and numerous anthropometric measures have been proposed as proxy indicators of adiposity. We aimed to assess prevalence of MetS in young adult population and to make comparison between weight- and shape-oriented measures of adiposity to identify the best index in association with measured body fat and as a risk predictor for MetS. Healthy males and females aged 18-25 years from the Northwest of England were recruited using convenience sampling (n=550). As part of the assessment of the overall health of young adults, the biochemical variables and adiposity measures BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), new BMI, Body Adiposity Index (BAI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and A Body Shape Index (ABSI) were assessed. Linear regression analysis was used to investigate the association between the proxy indices of adiposity and measured percentage body fat. The odds ratio with 95% confidence interval was used to investigate the relationship between cardiometabolic (CM) risk factors and proxy measures of adiposity. The discriminatory power of these measures for diagnosis of MetS was investigated using area under the receiver operating characteristic curve. Body weight-related indicators of adiposity, particularly CUN-BAE, had stronger association with measured body fat compared with body shape-related indices. In relation with MetS, body shape-related indices, particularly elevated WC and WHtR, had stronger associations with CM risk compared with body weight-related measures. Amongst all indices, the best predictor for CM risk was WHtR, while ABSI had the weakest correlation with body fat, MetS, and CM risk. Indices directly associated with WC and specifically WHtR had greater diagnostic power in detection of CM risk in young adults.

The Olivetti Heart Study: Predictive value of a new adiposity index on risk of hypertension, blood pressure, and subclinical organ damage

BACKGROUND AND AIMS

Recently, some studies have indicated that a new anthropometric index, body adiposity index (BAI), could be more strongly correlated with the percentage of body fat than BMI. However, the results on its role in predicting cardiovascular risk were not univocal. Therefore, the aim of our study was to compare the predictive role of BMI and BAI on risk of hypertension (HP), blood pressure (BP) changes, and subclinical organ damage after an 8-year follow-up, in a sample of adult men participating in the Olivetti Heart Study.

METHODS AND RESULTS

Participants were 350 untreated normotensive men without diabetes, examined twice at baseline (1994-95) and after 8 years of follow-up [2002-04]. BMI was expressed as kg/m(2). BAI was calculated according to the following formula: [(hip circumference (cm)/height(1.5) (m)) - 18]. Subclinical organ damage was detected by urinary albumin excretion (UAE) and left ventricular mass, evaluated by the Cornell product (CP). At baseline, BAI and BMI were both associated with diastolic blood pressure (DBP) and mean arterial pressure (MAP). After 8 years, both baseline BAI and BMI were associated with changes (Δ) in systolic BP, MAP and pulse pressure, while only BMI was also positively related to ΔDBP. Analysis of HP incidence showed that both indices were significant predictors of HP. In addition, both BAI and BMI were significantly associated with ΔUAE, but not with ΔCP. Analysis of the changes in BAI and BMI confirmed these results, as the two indices were significantly associated with risk of HP and changes in BP and UAE, but not with changes in CP.

CONCLUSIONS

In this sample of healthy adult men, BAI and BMI were significant predictors of risk of HP and changes in BP, after an 8-years follow-up. In addition both indices predicted UAE changes, but neither was associated with the CP changes.

Body shape, adiposity index, and mortality in postmenopausal women: Findings from the Women's Health Initiative

OBJECTIVE

Studies evaluating the relationship between body mass index (BMI) and mortality demonstrate a U-shaped association. To expand, this study evaluated the relationship between adiposity indices, a body shape index (ABSI) and body adiposity index (BAI), and mortality in 77,505 postmenopausal women.

METHODS

A prospective cohort analysis was conducted in the Women's Health Initiative to ascertain the independent relationships between adiposity indices and mortality in order to inform on the clinical usefulness of alternate measures of mortality risk. ABSI (waist circumference (cm)/[BMI(2/3) × height (cm)(1/2) ]), BAI (hip circumference (cm)/[height (m)(1.5) ] - 18), weight, BMI, and waist circumference (WC) were evaluated in relation to mortality risk using adjusted Cox proportional hazards regression models.

RESULTS

ABSI showed a linear association with mortality (HR, 1.37; 95% CI, 1.28-1.47 for quintile 5 vs. 1) while BMI and BAI had U-shaped relationships with HR of 1.30; 95% CI, 1.20-1.40 for obesity II/III BMI and 1.06, 95% CI, 0.99-1.13 for BAI. Higher WC (HR, 1.21; 95% CI, 1.13-1.29 for quintile 5 vs. 1) showed relationships similar to BMI.

CONCLUSIONS

ABSI appears to be a clinically useful measure for estimating mortality risk, perhaps more so than BAI and BMI in postmenopausal women.

The associations of "fatness," "fitness," and physical activity with all-cause mortality in older adults: A systematic review

OBJECTIVE

This review explored whether cardiorespiratory fitness or physical activity act as either confounders or effect modifiers of the relationship between adiposity markers and all-cause mortality in older adults.

METHODS

Systematic searches were carried out to identify observational studies that examined the association of adiposity markers (BMI, waist circumference, and waist-hip ratio) with all-cause mortality in adults aged ≥ 60 which took into account cardiorespiratory fitness or physical activity. Data from each included study was analyzed to produce a graphical representation of this relationship.

RESULTS

Fourteen of the fifteen identified studies found that increasing BMI had a non-positive association with all-cause mortality, with persistence of the obesity paradox despite adjustment for physical activity or cardiorespiratory fitness. Physical activity measurement methods were all subjective and often unvalidated. The two studies stratifying for cardiorespiratory fitness did not find that fitness had a significant impact on the relationship between excess adiposity and mortality but found that overweight and fit people had better survival than normal-weight unfit people,

CONCLUSIONS

The predominant use of poor physical activity measurement suggests that studies are currently not adequately accounting for possible physical activity confounding. More studies are needed for addressing the modification of the relationship between adiposity markers and mortality by cardiorespiratory fitness.

The validity of the body adiposity index in predicting percentage body fat and cardiovascular risk factors among Chinese

OBJECTIVE

Recent research has suggested that body adiposity index (BAI) correlates more closely with percentage body fat (PBF) than body mass index (BMI). Here, we aimed to evaluate BAI's predictive power for PBF and for obesity-associated risk factors in the Chinese population.

SUBJECTS

A total of 1707 women and 680 men aged 51-77 years were analysed in this community-based cross-sectional study.

MEASUREMENTS

Body weight, height, waist circumference (WC) and hip circumference (HC) were measured, and BMI and BAI were calculated. Percentage body fat was determined by dual-energy X-ray absorptiometry (DXA). Blood pressure, fasting lipid profiles, glucose and Carotid ultrasound examination determined intima-media thickness (IMT) at the common carotid arteries (CCA) were also measured.

RESULTS

The Pearson correlation analysis indicated a stronger correlation between BAI and PBF when women and men were pooled together, but this effect disappeared in sex-stratified analysis. Bland-Altman plots suggested that BAI underestimated 5·8% of PBF in women and slightly overestimated 0·28% of PBF in men, but the magnitudes of these biases showed a fat mass-dependent manner. Both the logistic regression and the receiver operating characteristic curve (ROC) analysis indicated that BAI has an inferior predictive power for the presence of hypertension, dyslipidaemia, metabolic syndrome and CCA-intima-media thickening, compared with BMI and WC.

CONCLUSION

We concluded that BAI was neither a better predictor for PBF nor for cardiovascular risks in Chinese population compared with BMI and WC.

Body adiposity index and incident hypertension: the Aerobics Center Longitudinal Study

BACKGROUND AND AIM

The body adiposity index (BAI) has been recently proposed as a new method to estimate the percentage of body fat. The association between BAI and hypertension risk has not been investigated yet. The aim of our study was to evaluate the ability of BAI to predict hypertension in males and females compared with traditional body adiposity measures.

METHODS AND RESULTS

The present follow-up analysis comprised 10,309 individuals (2259 females) free of hypertension from the Aerobics Center Longitudinal Study, who completed a baseline examination between 1988 and 2003. Body adiposity measures included BAI, body mass index (BMI), waist circumference, hip circumference, percentage of body fat and waist to hip ratio (WHR). Incident hypertension was ascertained from responses to mail-back surveys between 1990 and 2004. During an average of 9.1 years of follow-up, 872 subjects (107 females) became hypertensive. Hazard ratios (HRs) and 95% confidence intervals (95% CI) showed that males in the highest categories of all body adiposity measures showed a higher incident risk of hypertension (HRs ranged from 1.37 to 2.09). Females showed a higher incident risk of hypertension only in the highest categories of BAI, BMI and WHR (HRs ranged from 1.84 to 3.36).

CONCLUSION

Our results suggest that in order to predict incident hypertension BAI could be considered as an alternative to traditional body adiposity measures.

Obesity as assessed by body adiposity index and multivariable cardiovascular disease risk

To assess the role of body adiposity index (BAI) in predicting cardiovascular disease (CVD) and coronary heart disease (CHD) mortality, in comparison with body mass index (BMI), waist circumference (WC), and the waist circumference to hip circumference ratio (WHR). This study was a prospective 15 year mortality follow-up of 4175 Australian males, free of heart disease, diabetes and stroke. The Framingham Risk Scores (FRS) for CHD and CVD death were calculated at baseline for all subjects. Multivariable logistic regression was used to assess the effects of the measures of obesity on CVD and CHD mortality, before adjustment and after adjustment for FRS. The predictive ability of BAI, though present in the unadjusted analyses, was generally not significant after adjustment for age and FRS for both CVD and CHD mortality. BMI behaved similarly to BAI in that its predictive ability was generally not significant after adjustments. Both WC and WHR were significant predictors of CVD and CHD mortality and remained significant after adjustment for covariates. BAI appeared to be of potential interest as a measure of % body fat and of obesity, but was ineffective in predicting CVD and CHD.

Multiple adipose depots increase cardiovascular risk via local and systemic effects

Adipose tissue modifies the development of cardiovascular disease in a complex manner: obesity is a major risk factor, especially when accompanied by a central fat distribution. For that reason the characteristics of visceral adipose tissue have attracted most of the research interest thus far, and measurement of waist circumference is now recommended for everyday clinical practice. However, the direct, causative role of visceral fat in cardiometabolic disease remains to be established. Epidemiological and clinical studies show that accumulation of fat subcutaneously, in the gluteofemoral area, is protective against cardiovascular disease, but the exact molecular mechanisms remain unclear. In the last few years, imaging has allowed the study of smaller fat depots that may interact locally with important tissues: epicardial fat with the myocardium, perivascular fat with the vessel wall and the developing atherosclerotic plaque, and renal sinus fat with the renal artery. Unraveling the heterogeneous fat distribution and metabolic phenotypes in human obesity will facilitate optimal assessment of cardiovascular risk in overweight and obese individuals.