ABSI (A Body Shape Index) and ARI (Anthropometric Risk Indicator) in Bariatric Surgery. First Application on a Bariatric Cohort and Possible Clinical Use
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BMI (body mass index) is used to identify candidates for bariatric surgery, with a criterion of BMI ≥ 40. For lesser degrees of obesity, BMI 35–39.9, comorbidities are also considered. A Body Shape Index (ABSI) was derived to correct WC (waist circumference) for BMI and height. ABSI has been shown to be a linear predictor of long-term mortality across the range of BMI. Anthropometric risk indicator (ARI) combines the complementary contributions of BMI and ABSI and further improves mortality hazard prediction. We report for the first time ABSI and ARI for a bariatric surgical cohort at baseline and with 3-year follow-up.
ABSI and BMI were calculated for 101 subjects from our bariatric surgery center database at baseline and after 3 years of follow-up. Raw values for BMI and ABSI were converted to Z scores and ARI values based on sex- and age-specific normals and risk associations from the National Health and Nutrition Examination Survey (NHANES) III sample of the US general population.
Baseline scores for the anthropometric variables BMI and ABSI and the corresponding ARI were all higher than for the NHANES population sample. At 3-year post surgery, all three measures decreased significantly. While baseline BMI did not predict the change in mortality risk by ARI, baseline ABSI did (r = − 0.73), as did baseline ARI (r = − 0.94).
Sleeve gastrectomy lowers ABSI and the associated mortality risk estimated from population studies after 3 years of follow-up. Considering our results, bariatric surgical candidates with BMI in the range of 35 to 39.9 with an increased ABSI-related mortality risk may have considerable survival benefit from bariatric surgery, even in the absence of qualifying comorbidities.
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KeywordsABSI (A Body Shape Index) ARI (anthropometric risk indicator) Bariatric surgery Indications for bariatric surgery
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Conflict of Interest
The authors declare that they have no conflict of interest.
- 3.Kivimäki M, Kuosma E, Ferrie JE, et al. Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe. Lancet Public Health. 2017;2(6):e277–85. eCollection 2017 JunCrossRefPubMedPubMedCentralGoogle Scholar
- 4.WHO. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva: World Health Organization; 2013.Google Scholar
- 7.Berrigan D, et al. BMI and mortality: the limits of epidemiological evidence. Lancet. 2016;388(10046):734–736Google Scholar
- 8.Nazare JA, Smith JD, Borel AL, et al. Ethnic influences on the relations between abdominal subcutaneous and visceral adiposity, liver fat, and cardiometabolic risk profile: the international study of prediction of intra-abdominal adiposity and its relationship with cardiometabolic risk/intra-abdominal adiposity. Am J Clin Nutr. 2012 Oct;96(4):714–26. https://doi.org/10.3945/ajcn.112.035758.CrossRefPubMedGoogle Scholar
- 10.Yun CH, Bezerra HG, Wu TH, et al. The normal limits, subclinical significance, related metabolic derangements and distinct biological effects of body site-specific adiposity in relatively healthy population. PLoS One. 2013;8(4):e61997. https://doi.org/10.1371/journal.pone.0061997.CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Consalvo V, Salsano V. Three-trocar sleeve gastrectomy vs standard five-trocar technique: a randomized controlled trial. Obes Surg. 2017;27(12):3142–48. https://doi.org/10.1007/s11695-017-2760-0.
- 16.WHO. Waist circumference and waist-to-hip ratio: report of a WHO expert consultation. Geneva: WHO; 2008.Google Scholar
- 17.Pouliot M-C, Desprěs J-P, Lemieux S, et al. Waist circumference and abdominal sigittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73(7):460–3. https://doi.org/10.1016/0002-9149(94)90676-9.CrossRefPubMedGoogle Scholar