Abstract MP52: Beyond Body Mass Index: A Population-Based Comparison Demonstrates Advantages of Abdominal Anthropometry for Identifying Cardiometabolic Dysfunctions

Background: A weight-based adiposity indicator (body mass index; BMI, kg/m 2 ) is often reported for adults. Indicators based on sagittal abdominal diameter (SAD) or waist circumference have also identified cardiometabolic risk. Aim: Compare SAD/height ratio (SADHtR) or waist/height ratio (WHtR) with BMI for identifying risks in a representative sample of non-elderly adults without diagnosed diabetes. Outcome dysfunctions were Dysglycemia (glycated hemoglobin ≥5.7%), HyperNonHDLc (non-HDL-cholesterol ≥160 mg/dL or taking cholesterol meds), Hypertension (SBP ≥140 or DBP ≥90 or taking blood-pressure meds) and HyperALT (alanine transaminase ≥75 th %ile [sex-specific p75]). Methods: Non-pregnant adults (ages 20-64 y; N=3,071) in the 2011-2012 US National Health and Nutrition Examination Survey provided conventional anthropometry and supine SAD (by sliding - beam caliper). Sample weighting permitted estimation of population characteristics, including odds ratios (ORs) associated with each adiposity indicator (logistic regression models adjusted for age, sex and ancestry). For each dysfunction, we compared the ORs for 3 indicators after rescaling them to the indicator’s sex-specific, interquartile range. Results: The population distributions (mean; p25, p75) of indicators among men were: SADHtR (0.129; 0.112, 0.144), WHtR (0.564; 0.505, 0.613), and BMI (28.2; 24.2, 31.0). Among women they were: SADHtR (0.131; 0.112, 0.148), WHtR (0.580; 0.510, 0.636), and BMI (28.3; 23.4, 31.7). Dysfunction prevalence ranged from 21.9% (Dysglycemia in women) to 42.4% (HyperNonHDLc in men). To identify HyperNonHDLc, Hypertension and HyperALT (but not Dysglycemia), the ORs were highest for SADHtR and lowest for BMI. When SADHtR entered models simultaneously with BMI, the ORs associated with BMI no longer contributed to identification of HyperNonHDLc, Hypertension, or HyperALT (Figure). Conclusions: Among US adults, the SADHtR provides low-cost estimation of cardiometabolic risk independently of BMI.