Abstract
ObjectiveTo investigate whether bioelectrical impedance analysis could be used to identify overweight individuals at increased cardiometabolic risk, defined as the presence of metabolic syndrome and/or diabetes.Design and MethodsCross-sectional study of a Scottish population including 1210 women and 788 men. The diagnostic performance of thresholds of percentage body fat measured by bioelectrical impedance analysis to identify people at increased cardiometabolic risk was assessed using receiver-operating characteristic curves. Odds ratios for increased cardiometabolic risk in body mass index categories associated with values above compared to below sex-specific percentage body fat thresholds with optimal diagnostic performance were calculated using multivariable logistic regression analyses. The validity of bioelectrical impedance analysis to measure percentage body fat in this population was tested by examining agreement between bioelectrical impedance analysis and dual-energy X-ray absorptiometry in a subgroup of individuals.ResultsParticipants were aged 16-91 years and the optimal bioelectrical impedance analysis cut-points for percentage body fat for identifying people at increased cardiometabolic risk were 25.9% for men and 37.1% for women. Stratifying by these percentage body fat cut-points, the prevalence of increased cardiometabolic risk was 48% and 38% above the threshold and 24% and 19% below these thresholds for men and women, respectively. By comparison, stratifying by percentage body fat category had little impact on identifying increased cardiometabolic risk in normal weight and obese individuals. Fully adjusted odds ratios of being at increased cardiometabolic risk among overweight people with percentage body fat ≥25.9/37.1% compared with percentage body fat <25.9/37.1% as a reference were 1.93 (95% confidence interval: 1.20–3.10) for men and 1.79 (1.10–2.92) for women.ConclusionPercentage body fat measured using bioelectrical impedance analysis above a sex-specific threshold could be used in overweight people to identify individuals at increased cardiometabolic risk, who could benefit from risk factor management.
Highlights
Thresholds of body mass index (BMI) are used worldwide to identify people who are normal weight, overweight or obese
Percentage body fat measured using bioelectrical impedance analysis above a sex-specific threshold could be used in overweight people to identify individuals at increased cardiometabolic risk, who could benefit from risk factor management
As BMI measurement is a poor predictor of cardiometabolic risk, other simple alternative anthropometric measures have been tested, and waist circumference (WC), either alone or in combination with other anthropometric measurements is considered more useful for identifying individuals at increased cardiometabolic risk [3,4] than BMI [5]
Summary
Thresholds of body mass index (BMI) are used worldwide to identify people who are normal weight, overweight or obese. As BMI measurement is a poor predictor of cardiometabolic risk, other simple alternative anthropometric measures have been tested, and waist circumference (WC), either alone or in combination with other anthropometric measurements is considered more useful for identifying individuals at increased cardiometabolic risk [3,4] than BMI [5]. Since BIA is a simple, non-invasive, inexpensive and portable body composition method, it may be a useful screening technique when used in combination with BMI to identify individuals who are at increased cardiometabolic risk and need further investigation. Our aim was to test whether %BF measured by BIA would provide a useful addition to measurement of BMI to identify individuals who are at increased cardiometabolic risk, defined by the presence of the metabolic syndrome (using international consensus criteria [12]) and/or diabetes. The validity of BIA to measure %BF was tested by examining agreement between BIA and dual-energy X-ray absorptiometry (DXA) considered to be the ‘‘gold standard’’ [13] in a subgroup of individuals
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