Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as Predictors of Cardiovascular Disease Risk Factors in an Adult Population in Singapore

Abstract

BackgroundExcess adiposity is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus and dyslipidemia. Amongst the various measures of adiposity, the best one to help predict these risk factors remains contentious. A novel index of adiposity, the Body Adiposity Index (BAI) was proposed in 2011, and has not been extensively studied in all populations. Therefore, the purpose of this study is to compare the relationship between Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Body Adiposity Index (BAI) and CVD risk factors in the local adult population.Methods and FindingsThis is a cross sectional study involving 1,891 subjects (Chinese 59.1% Malay 22.2%, Indian 18.7%), aged 21–74 years, based on an employee health screening (2012) undertaken at a hospital in Singapore. Anthropometric indices and CVD risk factor variables were measured, and Spearman correlation, Receiver Operating Characteristic (ROC) curves and multiple logistic regressions were used. BAI consistently had the lower correlation, area under ROC and odd ratio values when compared with BMI, WC and WHtR, although differences were often small with overlapping 95% confidence intervals. After adjusting for BMI, BAI did not further increase the odds of CVD risk factors, unlike WC and WHtR (for all except hypertension and low high density lipoprotein cholesterol). When subjects with the various CVD risk factors were grouped according to established cut-offs, a BMI of ≥23.0 kg/m2 and/or WHtR ≥0.5 identified the highest proportion for all the CVD risk factors in both genders, even higher than a combination of BMI and WC.ConclusionsBAI may function as a measure of overall adiposity but it is unlikely to be better than BMI. A combination of BMI and WHtR could have the best clinical utility in identifying patients with CVD risk factors in an adult population in Singapore.

Cardiovascular Risk Factors among First Year Medical Students

“…[13] A combination of BMI and central obesity could have the best clinical utility in identifying patients with cardiovascular disease risk factors among adult patients. [14] So, we used BMI for obesity and waist circumference for central obesity in our study. After adjusting of cut-off value for BMI and waist circumference, we found 28.3% (n = 28, N = 99) of participants had higher BMI than the cutoff value and 1% (n = 1, N = 99) had greater waist circumference than the cut-off.…”

Estimation of Female Body Fat Percentage Based on Body Circumferences

“…Although high BMI has already been correlated with risk of arterial hypertension, 1,6 the method is limited because it does not differentiate lean body mass and fat mass in its calculation, making it difficult to use it as a predictive value of body fat percentage BF% and abdominal obesity. 7 As an alternative to BMI, Bergman et al 8 proposed the body adiposity index (BAI), an easily reproducible equation to estimate BF%.…”

Body Adiposity Index is Worse than Body Mass Index when Evaluating the Factors Associated with Adiposity in Elderly People

“…However, studies carried out in populations with different ethnic groups consistently reveal that the BAI tends to overestimate fatness in individuals with a lower percentage of body fat and underestimate body fat in those with higher adiposity [6][7][8]. Furthermore, BAI has better ability to predict body fat in the elderly compared to BMI only when data are not stratified by gender [6].…”