Surface-Based Body Shape Index and Its Relationship with All-Cause Mortality.

Donald Adjeroh,Syed Ashiqur Rahman,Li Wang

doi:10.1371/journal.pone.0144639

Abstract

BackgroundObesity is a global public health challenge. In the US, for instance, obesity prevalence remains high at more than one-third of the adult population, while over two-thirds are obese or overweight. Obesity is associated with various health problems, such as diabetes, cardiovascular diseases (CVDs), depression, some forms of cancer, sleep apnea, osteoarthritis, among others. The body mass index (BMI) is one of the best known measures of obesity. The BMI, however, has serious limitations, for instance, its inability to capture the distribution of lean mass and adipose tissue, which is a better predictor of diabetes and CVDs, and its curved (“U-shaped”) relationship with mortality hazard. Other anthropometric measures and their relation to obesity have been studied, each with its advantages and limitations. In this work, we introduce a new anthropometric measure (called Surface-based Body Shape Index, SBSI) that accounts for both body shape and body size, and evaluate its performance as a predictor of all-cause mortality.Methods and FindingsWe analyzed data on 11,808 subjects (ages 18–85), from the National Health and Human Nutrition Examination Survey (NHANES) 1999–2004, with 8-year mortality follow up. Based on the analysis, we introduce a new body shape index constructed from four important anthropometric determinants of body shape and body size: body surface area (BSA), vertical trunk circumference (VTC), height (H) and waist circumference (WC). The surface-based body shape index (SBSI) is defined as follows: SBSI=(H7/4)(WC5/6)BSAVTC(1) SBSI has negative correlation with BMI and weight respectively, no correlation with WC, and shows a generally linear relationship with age. Results on mortality hazard prediction using both the Cox proportionality model, and Kaplan-Meier curves each show that SBSI outperforms currently popular body shape indices (e.g., BMI, WC, waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), A Body Shape Index (ABSI)) in predicting all-cause mortality.ConclusionsWe combine measures of both body shape and body size to construct a novel anthropometric measure, the surface-based body shape index (SBSI). SBSI is generally linear with age, and increases with increasing mortality, when compared with other popular anthropometric indices of body shape.

Highlights

Obesity, with its dual complications of diabetes mellitus and cardiovascular disease (CVD), has emerged as a major public health challenge [1,2,3]
The body mass index (BMI), has serious limitations, for instance, its inability to capture the distribution of lean mass and adipose tissue, which is a better predictor of diabetes and CVDs, and its curved (“U-shaped”) relationship with mortality hazard
We introduce a new anthropometric measure that accounts for both body shape and body size, and evaluate its performance as a predictor of all-cause mortality

Summary

Introduction

With its dual complications of diabetes mellitus and cardiovascular disease (CVD), has emerged as a major public health challenge [1,2,3]. The picture for childhood and adolescent obesity is no better, with 16.9% obesity prevalence, and 31.8% classified as obese or overweight [5], and at the risk of developing insulin resistance, dyslipidemia, or hypertension at an early age [6]. This trend is mirrored by the high incidence of diabetes, which has shown a high prevalence rates [7]. Obesity is associated with various health problems, such as diabetes, cardiovascular diseases (CVDs), depression, some forms of cancer, sleep apnea, osteoarthritis, among others. We introduce a new anthropometric measure (called Surface-based Body Shape Index, SBSI) that accounts for both body shape and body size, and evaluate its performance as a predictor of all-cause mortality

Methods

Results

Conclusion