Abstract
BackgroundObesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD). Nonetheless, the best adiposity indices to evaluate the CVD risk factors remain contentious and few studies have been performed in Asian populations. In the present study, we compared the association strength of percent body fat (PBF) to indirect anthropometric measures of general adiposity (body mass index (BMI) and body adiposity index (BAI)) and central adiposity (waist circumference (WC), and waist-to-hip ratio (WHR)) for the prediction of CVD risk factors in healthy men and women living in Singapore.MethodsA total of 125 individuals (63 men and 62 women) took part in this study. PBF was measured by using three different techniques, including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Anthropometric measurements (WC, hip circumference (HC), height, and weight), fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were determined according to standard protocols. Correlations of anthropometric measurements and PBF with CVD risk factors were compared.ResultsIrrespective of the measuring techniques, PBF showed strong positive correlations with FSI, HOMA-IR, TC/HDL, TG/HDL, and LDL/HDL in both genders. While PBF was highly correlated with FBG, SBP, and DBP in females, no significant relationships were observed in males. Amongst the five anthropometric measures of adiposity, BAI was the best predictor for CVD risk factors in female participants (r = 0.593 for HOMA-IR, r = 0.542 for TG/HDL, r = 0.474 for SBP, and r = 0.448 for DBP). For males, the combination of WC (r = 0.629 for HOMA-IR, and r = 0.446 for TG/HDL) and WHR (r = 0.352 for SBP, and r = 0.366 for DBP) had the best correlation with CVD risk factors.ConclusionMeasurement of PBF does not outperform the simple anthropometric measurements of obesity, i.e. BAI, WC, and WHR, in the prediction of CVD risk factors in healthy Asian adults. While measures of central adiposity (WC and WHR) tend to show stronger associations with CVD risk factors in males, measures of general adiposity (BAI) seems to be the best predictor in females. The gender differences in the association between adiposity indices and CVD risk factors may relate to different body fat distribution in males and females living in Singapore. These results may find further clinical utility to identify patients with CVD risk factors in a more efficient way.Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-016-0114-4) contains supplementary material, which is available to authorized users.
Highlights
Obesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD)
All five adiposity indices (i.e. body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and body adiposity index (BAI)) were significantly correlated with fasting serum insulin (FSI), homeostasis model assessment of insulin resistance (HOMA-IR), TG, and TG/ high density lipoprotein (HDL)
Comparison of these adiposity indices in the strength of their correlations with CVD variables revealed that WC had the best correlation with HOMA-IR (r = 0.629), total cholesterol (TC)/ HDL (r = 0.315), and TG/HDL (r = 0.446)
Summary
Obesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD). Previous study has shown that obese subjects with the same amount of total body fat may have markedly different risk factor profiles [5]. Obese subjects with a normal metabolic risk profile (known as metabolically healthy obese individuals) were generally characterized by low levels of visceral adipose tissue and by subcutaneous obesity [7]. Recent technological advances have made possible the accurate measurement of regional fat compartments using magnetic resonance imaging (MRI) and computed tomography (CT) [8]. These methods may be better predictors of obesity-related health risks, their applications in large epidemiological studies or clinical practice is, not feasible due to the complexity and high costs of the instrumentations
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