Net contribution and predictive ability of the CUN-BAE body fatness index in relation to cardiometabolic conditions

Abstract

Background The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). Methods The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. Results The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07-1.21) and MetS (OR 1.48, 1.37-1.60), but not with diabetes (OR 1.05, 0.94-1.16). In subjects with a BMI < 25 kg/m 2 , CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. Conclusions The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings.

The Relation of CUN-BAE Index with Body Mass Index and Waist Circumference in Adults Aged 50 to 85 Years: The MCC-Spain Study

“…Additionally, the correlation improved greatly when the sample was stratified by sex; this coincides with the results of other studies [16,19,20,27]. Thus, by sex, the BMI and CUN-BAE correlation is strong (r > 0.94), while between WC and CUN-BAE, the correlation is somewhat lower (r 0.76-0.80).…”

“…In the current study, the correlation between CUN-BAE and BMI was very low. It was weaker than those observed in other studies in the general population [15][16][17]19,20,27]. The results of this study are original, as well as, CUN-BAE is an indirect index of BF and we do not have a gold standard, which means that a low correlation does not imply that BMI and WC are weaker indicators.…”

“…In the general population, CUN-BAE has shown stronger correlations with direct measures of BF% than other anthropometric measures such as BMI, WC, body adiposity index (BAI), or body shape index (ABSI) [12,17,[19][20][21]. CUN-BAE-based on BMI, sex, and age-has been shown to be an independent measure of BMI [16].…”

“…This is an adiposity estimator based on BMI, sex, and age in Caucasian adults [13,14]. The CUN-BAE index was proposed as a better indicator of BF than BMI or WC in adults to predict cardiovascular disease and other outcomes, as well as, it might be better able to identify metabolically unhealthy individuals [15][16][17][18][19]. Therefore, the Spanish Society for the Study of Obesity (SEEDO) has promoted the use of CUN-BAE in strategies of obesity prevention since 2016 [11]; however, the evidence on the CUN-BAE is not convincing.…”

Anthropometric indices and cut-off points in the diagnosis of metabolic disorders

“…When both sexes were analyzed separately, the BMI had the largest AUC in men and the WHtR and BRI had the largest AUCs in women. Similar to the results of our analysis in men, Davila-Batista et al concluded that the CUN-BAE was the best index for the identification of individuals with hypertension, diabetes, and MetS [35]. Corbatón Anchuelo et al emphasize the advantages of using the WC and WHtR in the identification of cardiometabolic disorders in women [16].…”