Relative fat mass, a new index of adiposity, is strongly associated with incident heart failure: data from PREVEND

Body-mass index (BMI), waist circumference, and waist-hip ratio are commonly used anthropometric indices of adiposity. However, over the past 10 years, several new anthropometric indices were developed, that more accurately correlated with body fat distribution and total fat mass. They include relative fat mass (RFM), body-roundness index (BRI), weight-adjusted-waist index and body-shape index (BSI). In the current study, we included 8295 adults from the PREVEND (Prevention of Renal and Vascular End-Stage Disease) observational cohort (the Netherlands), and sought to examine associations of novel as well as established adiposity indices with incident heart failure (HF). The mean age of study population was 50 ± 13 years, and approximately 50% (n = 4134) were women. Over a 11 year period, 363 HF events occurred, resulting in an overall incidence rate of 3.88 per 1000 person-years. We found that all indices of adiposity (except BSI) were significantly associated with incident HF in the total population (P < 0.001); these associations were not modified by sex (P interaction > 0.1). Amongst adiposity indices, the strongest association was observed with RFM [hazard ratio (HR) 1.67 per 1 SD increase; 95% confidence interval (CI) 1.37–2.04]. This trend persisted across multiple age groups and BMI categories, and across HF subtypes [HR: 1.76, 95% CI 1.26–2.45 for HF with preserved ejection fraction; HR 1.61, 95% CI 1.25–2.06 for HF with reduced ejection fraction]. We also found that all adiposity indices (except BSI) improved the fit of a clinical HF model; improvements were, however, most evident after adding RFM and BRI (reduction in Akaike information criteria: 24.4 and 26.5 respectively). In conclusion, we report that amongst multiple anthropometric indicators of adiposity, RFM displayed the strongest association with HF risk in Dutch community dwellers. Future studies should examine the value of including RFM in HF risk prediction models.

Utility of Three Adiposity Indices for Identifying Left Ventricular Hypertrophy and Geometric Remodeling in Chinese Children

BackgroundPrevious studies have shown that waist-to-height ratio (WHtR) performed similarly well when compared to body mass index (BMI) and waist circumference (WC) for identifying cardiovascular risk factors. However, to our knowledge, the performance of these three adiposity indices for identifying left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling in youth has not been assessed. We aimed to determine the utility of BMI, WC and WHtR for identifying LVH and LVG in Chinese children.MethodsThis study included 1,492 Chinese children aged 6-11 years. Adiposity indices assessed were BMI, WC and WHtR. LVH and high relative wall thickness (RWT) were defined using sex- and age-specific 90th percentile values of left ventricular mass index and RWT, respectively, based on the current population. LVG remodeling included concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH), which was defined based on the combination of LVH and high RWT.ResultsThe magnitude of association of central obesity defined by WHtR with LVH [odds ratio (OR) =10.09, 95% confidence interval (CI) =6.66-15.29] was similar with general obesity defined by BMI (OR=10.49, 95% CI=6.97-15.80), and both were higher than central obesity defined by WC (OR=6.87, 95% CI=4.57-10.33). Compared with BMI, WHtR had better or similar predictive utility for identifying LVH, EH, and CH [the area under the curve (AUC): 0.84 vs. 0.79; 0.84 vs. 0.77; 0.87 vs. 0.88, respectively]; WC had worse or similar discriminatory utility with AUCs of 0.73, 0.70, 0.83, respectively.ConclusionWHtR performed similarly or better than BMI or WC for identifying LVH and LVG remodeling among Chinese children. WHtR provides a simple and convenient measure of central obesity that might improve the discrimination of children with cardiac structural damage.

DO ADIPOSITY INDICES INFLUENCE VO2 MAX WITHIN NORMAL LIMITS? FITNESS VS. FATNESS

Introduction: The global burden of obesity doubled in children, tripled in adolescents and adults between 1975 and 2016.The central obesity is strongly associated with risk of type 2 diabetes and coronary artery diseases.Therefore,it is important to screen/detect obesity and its complications in early stages.Aim: of this study is to evaluate early markers of adult overweight/obesity, visceral obesity and aerobic fitness in young, healthy men, and also to find out association between visceral obesity and VO max as adequate research data is not available in this field. Forty young, 2 Methods: healthy adult men (aged 18-40 years) were randomly selected from the population of Vijayapura,Karnataka,India,in this study. The anthropometric parameters; weight, height, BMI, BSA, waist circumference and hip circumference were measured. The waist-hip ratio, Conicity index and A Body surface Index were calculated.VO max was measured by 2 Rockport 1-Mile walk test. A series of Pearson's correlation tests were performed to find out the influence of visceral adiposity indices on aerobic fitness. Results: All anthropometric parameters and adiposity indices measured in our study were within the normal range.A significant positive correlation was observed between age vs conicity index and age vs ABSI.We also found a significant negative correlation between adiposity indices and VO max in young healthy 2 adult males. Conclusion: Waist circumference, waist-hip ratio, conicity index and ABSI can be considered as useful anthropometric tools to diagnose central/visceral obesity in healthy men with normal BMI.Total fat and visceral fat may probably have some negative influence on cardiorespiratory function and aerobic fitness.

Associations of Novel Indices of Adiposity with Incident Heart Failure

Objective: To examine associations of newly-developed adiposity indices with incident heart failure (HF).Participants and Methods: The current study included 8493 adults from the PREVEND observational cohort (mean age: 49.8 years; 50% women). Exposures included novel adiposity indices i.e., relative fat mass (RFM), body-roundness index (BRI), weight-adjusted-waist index and body-shape index (BSI), as well as established adiposity indices i.e., body-mass index (BMI), waist circumference, and waist-hip ratio (WHR). Main outcome was development of incident HF.Results: The prevalence of overweight (BMI: 25-30kg/m2) and obesity (BMI≥30kg/m2) were 41% and 17% respectively. During 11.3±3.1 years of follow-up, 372 HF events were recorded, resulting in an overall HF incidence of 3.88 per 1000 person-years. All novel adiposity indices, except BSI, were significantly associated with incident HF (P<0.001). BMI, WC and WHR were also significantly associated with incident HF (P<0.001). Sex did not modify the association of any adiposity index with incident HF (Pint>0.1). Amongst adiposity indices, RFM displayed the strongest effect sizes (HR:1.67, 95%CI, 1.37-2.03). This trend persisted across multiple age categories, BMI categories and also among HF subtypes. All obesity measures, except BSI, improved the fit of the clinical HF model. Strongest improvement was observed after adding BRI and RFM (reduction in Akaike information criteria: 26.5 and 24.4 respectively).Conclusions: Relative fat mass is strongly associated with incident HF in the community. Future studies should examine the value of novel adiposity indices in HF risk estimation.

Independent and joint associations of body mass index, waist circumference, waist-height ratio and their changes with risks of hyperuricemia in middle-aged and older Chinese individuals: a population-based nationwide cohort study

Background Previous reports regarding the predictive power of adiposity indices remain inconsistent, and longitudinal studies on this top are limited. The associations of hyperuricemia risk with changes in obesity status, as well as the joint effects of baseline adiposity indices and body adiposity change on hyperuricemia risk are not fully elucidated. This study aimed to explore the independent and joint associations of baseline adiposity indicators and body adiposity change with hyperuricemia risk among middle-aged and older population in China. Methods A total of 2895 participants aged ≥ 45 years from the baseline survey of the China Health and Retirement Longitudinal Study were followed up for 4 years. Anthropometric parameters (weight, height, and waist circumference) and serum uric acid were obtained using standard devices. Adjusted odds ratio and 95% confidential interval were calculated to estimate the associations between predictor variables and hyperuricemia risk using multivariate logistic regression. Results Of the 2895 participants, 293 (10.12%) cases of hyperuricemia were identified. Increased baseline body mass index (BMI), waist circumference, and waist-height ratio (WHtR) were significantly associated with higher risks of hyperuricemia. A slightly greater but non-significant area under the curve value was observed for waist circumference (0.622) than for BMI (0.611) and WHtR (0.614) (P = 0.447). Compared to subjects with stable adiposity status, participants with weight loss of ≥ 4 kg or waist circumference loss of ≥ 6 cm had a 56% or 55% lower risk of hyperuricemia, and those with weight gain of > 4 kg had a 1.62-fold higher risk of hyperuricemia. Compared to those without obesity, participants with incident or persistent obesity were more likely to develop hyperuricemia. Additionally, regardless of stable or increased weight/waist circumference during follow-up, individuals with obesity at baseline had a higher risk of incident hyperuricemia. Conclusion This study demonstrates that BMI, waist circumference, and WHtR equally predict the development of hyperuricemia, and weight loss and waist circumference reduction are favorable in preventing hyperuricemia.