Issue of Waist Circumference for the Diagnosis of Metabolic Syndrome Regarding Arterial Stiffness: Possible Utility of a Body Shape Index in Middle-Aged Nonobese Japanese Urban Residents Receiving Health Screening

<b><i>Introduction:</i></b> Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with “A Body Shape Index (ABSI),” an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI). <b><i>Methods:</i></b> A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0. <b><i>Results:</i></b> CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = −0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate &#x3c;60 mL/min/1.73 m². Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI. <b><i>Discussion/Conclusion:</i></b> Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.

The a Body Shape Index Might Be a Stronger Predictor of Chronic Kidney Disease Than BMI in a Senior Population

The A Body Shape Index (ABSI) was recently introduced to quantify abdominal adiposity relative to the body mass index (BMI) and height. This cross-sectional study was performed to explore whether the ABSI is linked to chronic kidney disease (CKD) in older adults and compare the predictive capacity of the ABSI versus BMI for CKD. In total, 7053 people aged ≥ 60 years were divided into normal, mild, and moderate-to-severe CKD groups based on their estimated glomerular filtration rate (eGFR). The correlation of the ABSI with the eGFR and the differences and trends in the ABSI and BMI among the groups were analyzed, and the cutoff points for moderate-to-severe CKD were calculated. The association between the ABSI and CKD was stronger than that between the BMI and CKD. The ABSI had a better capacity to discriminate the CKD stage than did the BMI. The capacity of the ABSI to predict moderate-to-severe CKD was higher than that of the BMI and was more substantial in women than men. The ABSI cutoff points for CKD were ≥0.0822 and 0.0795 in men and women, respectively. In conclusion, the ABSI serves as a better index than the BMI for screening and detecting high-risk individuals with CKD.

Enhanced prediction of renal function decline by replacing waist circumference with “A Body Shape Index (ABSI)” in diagnosing metabolic syndrome: a retrospective cohort study in Japan

Background Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. Objective To examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline. Subjects/Methods In total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII. Results In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis. Conclusion In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.

Effectiveness of Body Roundness Index (BRI) and a Body Shape Index (ABSI) in Predicting Hypertension: A Systematic Review and Meta-Analysis of Observational Studies

Introduction: The body roundness index (BRI) and a body shape index (ABSI) are novel anthropometric indices established to determine both the amount visceral adipose tissue and body fat. Objective: to investigate whether BRI and ABSI are better predictors of hypertension than body mass index (BMI), waist circumference (WC) or waist-to-height ratio (WHtR). Methods: A systematic search was conducted in the Scopus, PubMed and Web of Science databases up until 31 December 2020. Results: The estimated pooled area under curve [AUC (95% CI)] for BRI [0.67 (0.65–0.70)] for the prediction of hypertension were superior to that of ABSI (0.58 (0.56–0.60)), similar to that of BMI [0.67 (0.64–0.69)], and lower than those WC [0.68 (0.66–0.70)] and WHtR [0.68 (0.66–0.71)]. Nevertheless, the difference of BRI compared to WC and WHtR in the context of predicting hypertension was non-significant. ABSI was significantly lower (p < 0.05) than BRI, BMI, WC and WHtR. Similar findings were observed with the summary receiver operating characteristic curve (AUC-SROC). There were no significant differences between subgroups according to type of population or diagnostic criteria of hypertension. The diagnostic odds ratio (dORs) proved that increased BRI and ABSI were related with an elevated hypertension risk. Conclusions: BRI and ABSI have discriminatory power for hypertension in adult women and men from different populations. Although, WHtR and WC provided the best performance when assessing hypertension, no significant differences were found for BRI. Finally, BRI was significantly better predictor of hypertension than ABSI.

A body shape index is associated with endothelial dysfunction in both men and women

A body shape index (ABSI) was proposed for estimation of abdominal adiposity. ABSI has been reported to have associations with cardiovascular risk factors and cardiovascular events. However, there is no information on the association between ABSI and endothelial function. We examined cross-sectional associations of ABSI with endothelial function in 8823 subjects (6773 men and 2050 women). Subjects with a lower quartile of flow-mediated vasodilation (FMD) were defined as subjects having endothelial dysfunction. Pearson’s correlation coefficient analysis revealed that ABSI was negatively correlated with FMD (men, r = − 0.23, P = 0.003; women, r = − 0.32, P < 0.001). The areas under the curves of ABSI and body mass index to predict endothelial dysfunction were 0.64 (95% confidence interval [CI] 0.62–0.65) and 0.58 (95% CI 0.57–0.60) in men, and 0.68 (95% CI 0.66–0.71) and 0.59 (95% CI 0.56–0.61) in women, respectively. The cutoff values of ABSI for predicting subjects with endothelial dysfunction were 0.0796 (sensitivity, 55.2%; specificity, 65.5%) in men and 0.0823 (sensitivity, 56.2%; specificity, 73.4%) in women. Multivariate analysis revealed that an ABSI value higher than the cutoff value remained an independent predictor of endothelial dysfunction in both sexes. The results of our study suggest that ABSI calculation should be performed for evaluation of risk of cardiovascular events in both men and women.Clinical trial registration information URL for Clinical Trial: https://www.umin.ac.jp/ctr/index.htm; Registration Number for Clinical Trial: UMIN000012952 (01/05/2010).

Original Article (Clinical Investigation) Enhanced Prediction of Renal Function Decline by Replacing Waist Circumference With “a Body Shape Index (Absi)” in Diagnosing Metabolic Syndrome: A Retrospective Cohort Study in Japan

Background: Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. We aimed to examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index, in MetS diagnosis is useful for predicting renal function decline (RFD). Methods: A retrospective cohort study was conducted in 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI), and high CAVI was defined as CAVI ≥ 9.0. The predictability of the occurrence of RFD (eGFR < 60 mL/min/1.73m 2 ) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Results: In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan-Meier analysis of the rate of new-onset RFD over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSIMetS than in those without (log-rank test p <0.001), but almost no difference between subjects with and without WC-MetS ( p = 0.014-0.617). In Cox analysis including gender, high CAVI and low-density lipoprotein‒cholesterol ≥140 mg/dL as confounders, only ABSI-MetS diagnosed by Japanese criteria contributed independently to the occurrence of RFD (HR = 1.41, p = 0.011). High CAVI was also an independent contributor to the occurrence of RFD. In a subanalysis, ABSI-MetS diagnosed by Japanese criteria contributed significantly to the occurrence of RFD regardless of age or gender, while WC-MetS by Japanese criteria contributed significantly only in older women. Conclusion: In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of RFD and arterial stiffening. Further studies are needed to confirm whether MetS diagnosed using ABSI also predicts CVD.

Anthropometric indicators of obesity. Are the new indicators a better predictor of body fat content than BMI?

Anthropometric measurements are widely used in medicine, scientific research, but also in specialist medical care. Their proper use provides valuable information about the nutritional status, the adipose tissue and even the risk of comorbidities. Numerous scientific works question the usefulness of the BMI (body mass index), which is only an indirect measure of obesity. It does not take into account information on gender and age, and does not provide an answer on the distribution of body fat. Misclassification can result in serious deviations in the estimation of obesity-related effects. Therefore, the aim of this study is to present five new anthropometric obesity indicators as an alternative to BMI.In response to the dramatically growing problem of overweight and obesity, further exacerbated by the necessary restrictions related to the COVID-19 pandemic, it is necessary to search for precise, yet simple tools for assessing body composition that can be routinely used by individuals but also for population studies. Based on the literature review, five frequently described indicators were selected: Relative Fat Mass (RFM), A Body Shape Index (ABSI), Body Adiposity Index (BAI), Body Roundness Index (BRI) and CUN-BAE. Application possibilities and their effectiveness for the estimation of adipose tissue content and the risk of coexisting diseases are presented.Growing number of authors confirm the validity of using indicators such as RFM, BRI, CUN-BAE and ABSI. At the same time, researchers point to the need for further verification of their usefulness in clinical practice and public health.