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Anthropometric indices and their predictive ability on metabolic syndrome in west China

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Aims

To evaluate the relationship between anthropometric indices, including abdominal volume index (AVI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), conicity index (C index), body mass index (BMI), body roundness index (BRI), body adiposity index (BAI), A body shape index (ABSI) and cardiovascular risk factors, and their abilities to predict metabolic syndrome (MetS) in adults.

Methods

A cross-sectional study of 76,915 participants (30,912 females and 46,003 males) aged between 14 and 100 years was conducted. AVI, WHR, WHtR, BMI, conicity index (C index), BRI, BAI, and ABSI were measured and calculated. Pearson correlation analysis and linear regression analysis were used to examine the relationship between anthropometric indicators and the components of MetS, while binary logistic regression analysis was used to assess the relationship between anthropometric indicators and overall MetS. The receiver operating characteristic curve (ROC) was used to analyze and calculate the area under the curve (AUC). Then, a 95% confidence interval (95% CI) was calculated to evaluate the ability of anthropometric indicators to predict MetS and determine the optimal cutoff value of each anthropometric indicator. The optimal cutoff value was determined by the Youden index.

Results

MetS prevalence was 21.71% in males and 9.5% in females. Participants with MetS were older and had higher values of glucose, triglyceride, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP) than those without MetS. The high-density lipoprotein cholesterol (HDL-C) values of males and females with MetS were lower than the values found in those without MetS. Mean values of all anthropometric indicators in men and women with MetS were significantly higher than the mean values in those without MetS. After adjusting for age, alcohol consumption, and smoking, anthropometric indexes AVI, WHR, WHtR, C index, BMI, and BRI were all associated with cardiovascular risk factors (p < 0.001). Among men over the age 60 years old, an AVI cutoff of 16.0 predicted MetS with a sensitivity of 74.70% and a specificity of 84.90%. The area under the ROC curve was 0.84 (p < 0.001). Among women over the age of 60 years, an AVI cutoff of 12.8 predicted MetS with a sensitivity of 90.13% and a specificity of 63.72%. The area under the ROC curve was 0.80 (p < 0.001). Among men aged 30–60 years, an AVI cutoff of 16 predicted MetS with a sensitivity of 80.44% and a specificity of 82.36%. The area under the ROC curve was 0.85 (p < 0.001). Among women aged 30–60 years, an AVI cutoff of 12.82 predicted MetS with a sensitivity of 87.72% and a specificity of 83.47%. The area under the ROC curve was 0.90 (p < 0.001). Among men under the age of 30 years, an AVI cutoff of 16.22 predicted MetS with a sensitivity of 87.97% and a specificity of 88.65%. The area under the ROC curve was 0.92 (p < 0.001). Among women under the age of 30 years, an AVI cutoff of 12.79 predicted MetS with a sensitivity of 95.92% and a specificity of 93.79%. The area under the ROC curve was 0.97 (p < 0.001). AVI showed the strongest ability to distinguish MetS across genders and different age groups.

Conclusion

AVI, WHR, WHtR, BMI, C index, and BRI were all associated with cardiovascular risk factors. The anthropometric index is a useful screening tool for MS, its components, and cardiovascular risk factors. Among all the indices examined, AVI can best distinguish MetS.

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Data availability

The data used in this study were collected from the Health Management Center of West China Hospital. The data belongs to West China hospital. Those data are not publicly obtainable.

References

  1. Ma LY, Chen WW, Gao RL, Liu LS, Zhu ML, Wang YJ, et al. China cardiovascular diseases report 2018: an updated summary. J Geriatr Cardiol. 2020;17(1):1–8. https://doi.org/10.11909/j.issn.1671-5411.2020.01.001.

    Article  Google Scholar 

  2. Cleeman JI, Grundy SM, Becker D, Clark LT, Cooper RS, Denke MA, et al. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Jama-Journal of the American Medical Association. 2001;285(19):2486–97. https://doi.org/10.1001/jama.285.19.2486.

    Article  Google Scholar 

  3. Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep. 2018;20(2):12. https://doi.org/10.1007/s11906-018-0812-z.

    Article  Google Scholar 

  4. Gonzalez-Chávez A, Chávez-Fernández JA, Elizondo-Argueta S, González-Tapia A, León-Pedroza JI, Ochoa C. Metabolic syndrome and cardiovascular disease: a health challenge. Arch Med Res. 2018;49(8):516–21. https://doi.org/10.1016/j.arcmed.2018.10.003.

    Article  Google Scholar 

  5. Perissinotto E, Pisent C, Sergi G, Grigoletto F. Anthropometric measurements in the elderly: age and gender differences. Br J Nutr. 2002;87(2):177–86. https://doi.org/10.1079/bjn2001487.

    Article  CAS  Google Scholar 

  6. Steen B. Body composition and aging. Nutr Rev. 1988;46(2):45–51. https://doi.org/10.1111/j.1753-4887.1988.tb05386.x.

    Article  CAS  Google Scholar 

  7. Almeida NS, Rocha R, Cotrim HP, Daltro C. Anthropometric indicators of visceral adiposity as predictors of non-alcoholic fatty liver disease: a review. World J Hepatol. 2018;10(10):695–701. https://doi.org/10.4254/wjh.v10.i10.695.

    Article  Google Scholar 

  8. Guerrero-Romero F, Rodriguez-Moran M. Abdominal volume index. An anthropometry-based index for estimation of obesity is strongly related to impaired glucose tolerance and type 2 diabetes mellitus. Arch Med Res. 2003;34(5):428–32. https://doi.org/10.1016/s0188-4409(03)00073-0.

    Article  Google Scholar 

  9. Patil VC, Parale GP, Kulkarni PM, Patil HV. Relation of anthropometric variables to coronary artery disease risk factors. Indian J Endocr Metab. 2011;15(1):31–7. https://doi.org/10.4103/2230-8210.77582.

    Article  Google Scholar 

  10. Ruperto M, Barril G, Sanchez-Muniz FJ. Conicity index as a contributor marker of inflammation in haemodialysis patients. Nutr Hosp. 2013;28(5):1688–95. https://doi.org/10.3305/nh.2013.28.5.6626.

    Article  Google Scholar 

  11. Bergman RN, Stefanovski D, Buchanan TA, Sumner AE, Reynolds JC, Sebring NG, et al. A better index of body adiposity. Obesity. 2011;19(5):1083–9. https://doi.org/10.1038/oby.2011.38.

    Article  Google Scholar 

  12. Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PLoS One. 2012;7(7):e39504. https://doi.org/10.1371/journal.pone.0039504.

    Article  CAS  Google Scholar 

  13. Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen W, Gallagher D, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity. 2013;21(11):2264–71. https://doi.org/10.1002/oby.20408.

    Article  Google Scholar 

  14. Nevill AM, Duncan MJ, Lahart IM, Sandercock GR. Scaling waist girth for differences in body size reveals a new improved index associated with cardiometabolic risk. Scand J Med Sci Sports. 2017;27(11):1470–6. https://doi.org/10.1111/sms.12780.

    Article  CAS  Google Scholar 

  15. Lee DY, Lee MY, Sung KC. Prediction of mortality with a body shape index in young Asians: comparison with body mass index and waist circumference. Obesity. 2018;26(6):1096–103. https://doi.org/10.1002/oby.22193.

    Article  Google Scholar 

  16. Wu Q, Qin K, Wang Y. Central obesity is associated with helicobacter pylori infection: a large-scale cross-sectional retrospective study in West China. Int J Diabetes Dev Ctries. 2019;40(1):52–60. https://doi.org/10.1007/s13410-019-00765-8.

    Article  CAS  Google Scholar 

  17. Zhou CM, Zhan L, Yuan J, Tong XY, Peng YH, Zha Y. Comparison of visceral, general and central obesity indices in the prediction of metabolic syndrome in maintenance hemodialysis patients. Eating and Weight Disorders-Studies on Anorexia Bulimia and Obesity. 2020;25(3):727-34. doi:10.1007/s40519-019-00678-9.

    Article  Google Scholar 

  18. Nurjono M, Lee J. Waist circumference is a potential indicator of metabolic syndrome in Singaporean Chinese. Ann Acad Med Singapore. 2013;42(5):241–5.

    Article  Google Scholar 

  19. Ceolin J, Engroff P, Mattiello R, Schwanke CHA. Performance of Anthropometric Indicators in the Prediction of Metabolic Syndrome in the Elderly. Metabolic Syndrome and Related Disorders. 2019;17(4):232-9. doi:10.1089/met.2018.0113.

  20. Perona JS, Rio-Valle JS, Ramirez-Velez R, Correa-Rodriguez M, Fernandez-Aparicio A, Gonzalez-Jimenez E. Waist circumference and abdominal volume index are the strongest anthropometric discriminators of metabolic syndrome in Spanish adolescents. European Journal of Clinical Investigation. 2019;49(3):e13060. doi:10.1111/eci.13060.

  21. Perona JS, Schmidt-RioValle J, Fernandez-Aparicio A, Correa-Rodriguez M, Ramirez-Velez R, Gonzalez-Jimenez E. Waist Circumference and Abdominal Volume Index Can Predict Metabolic Syndrome in Adolescents, but only When the Criteria of the International Diabetes Federation are Employed for the Diagnosis. Nutrients. 2019;11(6):1370. doi:10.3390/nu11061370.

  22. Gadelha AB, Myers J, Moreira S, Dutra MT, Safons MP, Lima RM. Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrome in postmenopausal women. Diabetes Metab Syndr. 2016;10(3):143–8. https://doi.org/10.1016/j.dsx.2016.01.005.

    Article  Google Scholar 

  23. Despres J-P, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881–7. https://doi.org/10.1038/nature05488.

    Article  CAS  Google Scholar 

  24. Yang YJ, Park HJ, Won KB, Chang HJ, Park GM, Kim YG, et al. Relationship between the optimal cut-off values of anthropometric indices for predicting metabolic syndrome and carotid intima-medial thickness in a Korean population. Medicine. 2019;98(42):e17620. https://doi.org/10.1097/md.0000000000017620.

    Article  Google Scholar 

  25. Ko K-P, Oh D-K, Min H, Kim C-S, Park J-K, Kim Y, et al. Prospective study of optimal obesity index cutoffs for predicting development of multiple metabolic risk factors: the Korean genome and epidemiology study. J Epidemiol. 2012;22(5):433–9. https://doi.org/10.2188/jea.JE20110164.

    Article  Google Scholar 

  26. He YH, Chen YC, Jiang GX, Huang HE, Li R, Li XY, et al. Evaluation of anthropometric indices for metabolic syndrome in Chinese adults aged 40 years and over. Eur J Nutr. 2012;51(1):81–7. https://doi.org/10.1007/s00394-011-0195-2.

    Article  Google Scholar 

  27. Bener A, Yousafzai MT, Darwish S, Al-Hamaq AOAA, Nasralla EA, Abdul-Ghani M. Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. J Obes. 2013. https://doi.org/10.1155/2013/269038.

    Article  Google Scholar 

  28. Quaye L, Owiredu W, Amidu N, Dapare PPM, Adams Y. Comparative Abilities of Body Mass Index, Waist Circumference, Abdominal Volume Index, Body Adiposity Index, and Conicity Index as Predictive Screening Tools for Metabolic Syndrome among Apparently Healthy Ghanaian Adults. Journal of Obesity. 2019;2019:8143179. doi:10.1155/2019/8143179.

  29. Sinaga M, Worku M, Yemane T, Tegene E, Wakayo T, Girma T, et al. Optimal cut-off for obesity and markers of metabolic syndrome for Ethiopian adults. Nutr J. 2018;17(1):109. https://doi.org/10.1186/s12937-018-0416-0.

    Article  Google Scholar 

  30. Tian T, Zhang J, Zhu Q, Xie W, Wang Y, Dai Y. Predicting value of five anthropometric measures in metabolic syndrome among Jiangsu Province, China. BMC Public Health. 2020;20(1):1317. https://doi.org/10.1186/s12889-020-09423-9.

    Article  Google Scholar 

  31. Mamtani MR, Kulkarni HR. Predictive performance of anthropometric indexes of central obesity for the risk of type 2 diabetes. Arch Med Res. 2005;36(5):581–9. https://doi.org/10.1016/j.arcmed.2005.03.049.

    Article  Google Scholar 

  32. Motamed N, Sohrabi M, Poustchi H, Maadi M, Malek M, Keyvani H, et al. The six obesity indices, which one is more compatible with metabolic syndrome? A population based study. Diabetes Metab Syndr. 2017;11(3):173–7. https://doi.org/10.1016/j.dsx.2016.08.024.

    Article  Google Scholar 

  33. Wang H, Liu A, Zhao T, Gong X, Pang T, Zhou Y, et al. Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study. BMJ Open. 2017;7(9):e016062. https://doi.org/10.1136/bmjopen-2017-016062.

    Article  Google Scholar 

  34. Zhang XH, Zhang M, He J, Yan YZ, Ma JL, Wang K, et al. Comparison of anthropometric and atherogenic indices as screening tools of metabolic syndrome in the Kazakh adult population in Xinjiang. Int J Environ Res Public Health. 2016;13(4):428. https://doi.org/10.3390/ijerph13040428.

    Article  CAS  Google Scholar 

  35. Gharipour M, Sadeghi M, Dianatkhah M, Bidmeshgi S, Ahmadi A, Tahri M, et al. The cut-off values of anthropometric indices for identifying subjects at risk for metabolic syndrome in Iranian elderly men. Journal of obesity. 2014;2014:907149. https://doi.org/10.1155/2014/907149.

    Article  Google Scholar 

  36. Llinas MG, Janer PE, Agudo SG, Casquero RG, Gonzalez IC. Usefulness in nursing of different anthropometric and analytical indices to assess the existence of metabolic syndrome with the NCEP ATP III and IDF criteria in Spanish Mediterranean population. Medicina Balear. 2017;32(1):26–34. https://doi.org/10.3306/medicinabalear.32.01.26.

    Article  Google Scholar 

  37. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obesity Reviews. 2012;13(3):275-86. doi:10.1111/j.1467-789X.2011.00952.x.

    Article  CAS  Google Scholar 

  38. Han T, Williams K, Sattar N, Hunt K, Lean M, Haffner S. Analysis of obesity and hyperinsulinemia in the development of metabolic syndrome: San Antonio Heart Study. Obes Res. 2002;10:923–31. https://doi.org/10.1038/oby.2002.126.

    Article  Google Scholar 

  39. Guzman de la Garza FJ, Salinas-Martinez AM, Gonzalez-Guajardo E, Palmero-Hinojosa MG, Castro-Garza J, Ramirez-Zuniga JC, et al. Threshold values of sagittal abdominal diameter for the detection of cardio-metabolic risk factors in Northeastern Mexico: a cross-sectional study. Nutricion Hospitalaria. 2016;33(3):268. https://doi.org/10.20960/nh.268.

    Article  CAS  Google Scholar 

  40. Zhang GS, Yu CH, Luo LS, Li YC, Zeng XY. Trend analysis of the burden of ischemic heart disease in China, 1990 to 2015. Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]. 2017;51(10):915-21. doi:10.3760/cma.j.issn.0253-9624.2017.10.009.

    Article  CAS  Google Scholar 

  41. Arthur FK, Adu-Frimpong M, Osei-Yeboah J, Mensah FO, Owusu L. Prediction of metabolic syndrome among postmenopausal Ghanaian women using obesity and atherogenic markers. Lipids Health Dis. 2012;11:101. https://doi.org/10.1186/1476-511x-11-101.

    Article  CAS  Google Scholar 

  42. Williams CM. Lipid metabolism in women. Proceedings of the Nutrition Society. 2004;63(1):153–60. https://doi.org/10.1079/pns2003314.

    Article  CAS  Google Scholar 

  43. Zhang J, Zhu WH, Qiu LF, Huang LJ, Fang LZ. Sex- and age-specific optimal anthropometric indices as screening tools for metabolic syndrome in Chinese adults. Int J Endocrinol. 2018. https://doi.org/10.1155/2018/1067603.

    Article  Google Scholar 

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Acknowledgements

We give our thanks to the research group members in Health Management Center, West China Hospital, Sichuan University, for their generous support.

Funding

This work was supported by the Sichuan Science and Technology Program (Grant No. 2017RZ0046, Grant No. 2018SZ0087, Grant No. 2018HH0099), a grant from the Sichuan province health department (Grant No. Chuanganyan2012-111), and the Youth Teacher Research Startup Fund of Sichuan University (2016SCU11016).

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Authors

Contributions

Qinqin Wu and Hu Nie Designed the study, executed the study, analyzed the results, and contributed to the drafting of the manuscript. Qinqin Wu and Ken Qin Analyzed and interpreted the data in the revised version. Qinqin Wu and Youjuan Wang Contributed to designing the study and discussion of results, and the final manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Hu Nie.

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Ethics approval and consent to participate

This study was approved by the Ethics Committee of West China Hospital of Sichuan University. As this is a retrospective research, informed consent was not essential according to the Ethical Guidelines for Epidemiological Research. The study was allowed by the Ethics Committee of West China, Sichuan University.

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Not applicable.

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The authors declare no competing interests.

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Wu, Q., Qin, K., Wang, Y. et al. Anthropometric indices and their predictive ability on metabolic syndrome in west China. Int J Diabetes Dev Ctries 42, 666–682 (2022). https://doi.org/10.1007/s13410-021-01020-9

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