Predictive power of novel and established obesity indices for outcome in PAD during a five-year follow-up

Zierfuss, Bernhard; Höbaus, Clemens; Herz, Carsten Thilo; Pesau, Gerfried; Koppensteiner, Renate; Schernthaner, Gerit-Holger

doi:10.1016/j.numecd.2020.03.019

Cited by 15 publications

(15 citation statements)

References 44 publications

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“…There were 22 studies 92–113 (178,002 participants) with cardiovascular populations (Table S3): 7 cohorts in Europe, 6 in North America, 5 in East Asia, 2 were international cohorts, and 1 each West Asia and the Pacific. Mean age of participants ranged from 37 to 83 years.…”

Section: Resultsmentioning

confidence: 99%

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

2023

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SummaryFasting insulin and c‐reactive protein confound the association between mortality and body mass index. An increase in fat mass may mediate the associations between hyperinsulinemia, hyperinflammation, and mortality. The objective of this study was to describe the “average” associations between body mass index and the risk of mortality and to explore how adjusting for fasting insulin and markers of inflammation might modify the association of BMI with mortality. MEDLINE and EMBASE were searched for studies published in 2020. Studies with adult participants where BMI and vital status was assessed were included. BMI was required to be categorized into groups or parametrized as non‐first order polynomials or splines. All‐cause mortality was regressed against mean BMI squared within seven broad clinical populations. Study was modeled as a random intercept. β coefficients and 95% confidence intervals are reported along with estimates of mortality risk by BMIs of 20, 30, and 40 kg/m2. Bubble plots with regression lines are drawn, showing the associations between mortality and BMI. Splines results were summarized. There were 154 included studies with 6,685,979 participants. Only five (3.2%) studies adjusted for a marker of inflammation, and no studies adjusted for fasting insulin. There were significant associations between higher BMIs and lower mortality risk in cardiovascular (unadjusted β −0.829 [95% CI −1.313, −0.345] and adjusted β −0.746 [95% CI −1.471, −0.021]), Covid‐19 (unadjusted β −0.333 [95% CI −0.650, −0.015]), critically ill (adjusted β −0.550 [95% CI −1.091, −0.010]), and surgical (unadjusted β −0.415 [95% CI −0.824, −0.006]) populations. The associations for general, cancer, and non‐communicable disease populations were not significant. Heterogeneity was very large (I2 ≥ 97%). The role of obesity as a driver of excess mortality should be critically re‐examined, in parallel with increased efforts to determine the harms of hyperinsulinemia and chronic inflammation.

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Section: Resultsmentioning

confidence: 99%

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

2023

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“…When investigating the impact of VAI on prognostic prediction in patients with preexisting cardiovascular disease, nevertheless, VAI was not shown as a significant risk predictor for adverse prognosis (16,46). This study, which identified the significant prognostic impact of VAI in a specific high-risk group with NSTE-ACS and T2DM undergoing elective PCI, is an important exploration and supplement to previous studies.…”

Section: Discussionmentioning

confidence: 82%

“…A study has shown that VAI is not superior to common anthropometric measures in predicting the risk of cardiovascular disease ( 45 ). When investigating the impact of VAI on prognostic prediction in patients with preexisting cardiovascular disease, nevertheless, VAI was not shown as a significant risk predictor for adverse prognosis ( 16 , 46 ).…”

Section: Discussionmentioning

confidence: 96%

Visceral Adiposity Index Plays an Important Role in Prognostic Prediction in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome and Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention

Zhao

Cheng

et al. 2021

Front. Cardiovasc. Med.

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Background: Visceral adiposity index (VAI), a surrogate marker of adiposity and insulin resistance, has been demonstrated to be significantly related to cardiovascular disease. It remains indistinct whether VAI predicts adverse prognosis after percutaneous coronary intervention (PCI) for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and type 2 diabetes mellitus (T2DM).Methods: A total of 798 participants who met the enrollment criteria were finally brought into this study. VAI was determined by waist circumference, body mass index, fasting triglyceride, and high-density lipoprotein cholesterol as previously reported. Adverse prognosis included all-cause death, non-fatal myocardial infarction, non-fatal ischemic stroke, and ischemia-driven revascularization, the composite of which was defined as the primary endpoint.Results: Higher VAI maintained as a significant and independent risk predictor for the primary endpoint, regardless of the adjustment for the various multivariate models [hazard ratio (95% CI) for fully adjusted model: 2.72 (2.02–3.68), p < 0.001]. The predictive value of VAI was further confirmed in sensitivity analysis where VAI was taken as a continuous variate. There was a dose-response relationship of VAI with the risk of the primary endpoint (p for overall association < 0.001). Moreover, the ability of VAI on the prediction of the primary endpoint was consistent between subgroups stratified by potential confounding factors (all p for interaction > 0.05). VAI exhibited a significant incremental effect on risk stratification for the primary endpoint beyond existing risk scores, expressed as increased Harrell's C-index, significant continuous net reclassification improvement, and significant integrated discrimination improvement.Conclusion: VAI is a significant indicator for predicting worse prognosis and plays an important role in risk stratification among patients with NSTE-ACS and T2DM undergoing elective PCI. The present findings require further large-scale, prospective studies to confirm.

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“…Moreover, these two parameters, BAI and BFI, were more closely related to body fat, speci cally compared to BMI which has frequently been used. For this reason, we can state that BFI and BAI would be two more suitable tools to characterize global obesity [9,10]. It is clearly well established that these indicators are associated with WC and TG.…”

Section: Discussionmentioning

confidence: 99%

Obesity related to metabolic syndrome: Comparison of obesity indicators in an older French population

ASSOUMOU

Pichot

Barthélemy

et al. 2023

Preprint

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Objectives: Metabolic syndrome (MS) represents a cluster of metabolic abnormalities. Insulin resistance is a major component of the syndrome. We analyze in this study the relationship between body fat composition and MS in comparison to usual obesity indicators in an older adult population. Design: The PROgnostic indicator OF cardiovascular and cerebrovascular events (PROOF) study is a prospective longitudinal community cohort study among the inhabitants of Saint-Etienne, France Methods: The study is a cohort study of 1011 subjects (mean age 65.6±0.8 years old) recruited from the electoral list of the town in 2000. Among them, 806 subjects realized a Dual-energy X-ray absorptiometry (DXA) used to evaluate body fat and lean mass repartition. We evaluate biological metabolic parameters according to usual techniques. The indices of obesity were calculated according to standard formula. MS presence and components were simultaneously evaluated. Results: All physical parameters were significantly higher(p<0.0001) in subjects suffering metabolic syndrome as compared to those without. Body fat index (BFI) was distinguished from others with a strong correlation to total fat mass, trunk fat mass and body adiposity index (BAI). The correlations between body indices and metabolic components showed that body mass index (BMI) and waist circumference were more strongly associated with BFI as compared to BAI and total fat mass. According logistic regression analysis, only waist-hip ratio (WHR) demonstratedsignificant association with MS severity (p<0.0001). Conclusions: Among the obesity indices, BFI and BAI represented the best indicators to characterize global obesity while WHR is highly predictive of metabolic syndrome presence and severity. The BAI indicator is an alternative for measuring obesity in the absence of DXA measurements. Comparison of long-term impact of such markers on cardiovascular morbidity and mortality is now questioned.

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Predictive power of novel and established obesity indices for outcome in PAD during a five-year follow-up

Cited by 15 publications

References 44 publications

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

Visceral Adiposity Index Plays an Important Role in Prognostic Prediction in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome and Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention

Obesity related to metabolic syndrome: Comparison of obesity indicators in an older French population

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