Abstract
The body adiposity index (BAI) is a recent anthropometric measure proven to be valid in predicting body fat percentage (BF%) in some populations. However, the results have been inconsistent across populations. This study was designed to verify the validity of BAI in predicting BF% in a sample of overweight/obese adults, using dual-energy X-ray absorptiometry (DEXA) as the reference method. A cross-sectional study was conducted in 48 participants (54% women, mean age 41.0 ± 7.3 years old). DEXA was used as the “gold standard” to determine BF%. Pearson’s correlation coefficient was used to evaluate the association between BAI and BF%, as assessed by DEXA. A paired sample t-test was used to test differences in mean BF% obtained with BAI and DEXA methods. To evaluate the concordance between BF% as measured by DEXA and as estimated by BAI, we used Lin’s concordance correlation coefficient and Bland–Altman agreement analysis. The correlation between BF% obtained by DEXA and that estimated by BAI was r = 0.844, p < 0.001. Paired t-test showed a significant mean difference in BF% between methods (BAI = 33.3 ± 6.2 vs. DEXA 39.0 ± 6.1; p < 0.001). The bias of the BAI was −6.0 ± 3.0 BF% (95% CI = −12.0 to 1.0), indicating that the BAI method significantly underestimated the BF% compared to the reference method. Lin’s concordance correlation coefficient was considered stronger (ρc = 0.923, 95% CI = 0.862 to 0.957). In obese adults, BAI presented low agreement with BF% measured by DEXA; therefore, BAI is not recommended for BF% prediction in this overweight/obese sample studied.
Highlights
The high prevalence of overweight and obesity has become a public health problem worldwide [1].Several studies have illustrated a link between the accumulation of body adipose tissue, metabolic adverse events, and elevated high risk of developing insulin resistance, diabetes, dyslipidaemia, and hypertension [2,3,4]
Stratified analyses according to sex showed that among men, significant correlations were found for body mass index (BMI) (r = 0.739, p < 0.001), waist-to-height ratio (WHtR) (r = 0.639, p < 0.001), and BF% by dual-energy X-ray absorptiometry (DEXA)
The main finding was the lack of predictive validity of body adiposity index (BAI) for the estimation of BF% compared to DEXA in both sexes
Summary
The high prevalence of overweight and obesity has become a public health problem worldwide [1].Several studies have illustrated a link between the accumulation of body adipose tissue, metabolic adverse events, and elevated high risk of developing insulin resistance, diabetes, dyslipidaemia, and hypertension [2,3,4]. To estimate the magnitude of this problem, various methods are used to identify adults at risk for excess adiposity in order to prevent the development of overweight and obesity comorbidities. In this context, the precise measurement of body composition by sophisticated methods—such as magnetic resonance imaging, computed tomography, DEXA, isotopic measurement of body water, whole body plethysmography, bioelectrical impedance analysis, and underwater weighting [6]. The precise measurement of body composition by sophisticated methods—such as magnetic resonance imaging, computed tomography, DEXA, isotopic measurement of body water, whole body plethysmography, bioelectrical impedance analysis, and underwater weighting [6] These methods are costly, time-consuming, and frequently difficult to access. Other disadvantages of these techniques include lack of real-time feedback [6] and repeatability
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