Surrogate Biomarker to Identify Obesity and Predict Cardiovascular Disease Risk: A Systematic Review

Abstract

The study investigates the relationship between obesity and cardiovascular disease (CVD) risk, comparing the use of body mass index (BMI) versus other biomarkers in predicting CVD risk among obese individuals. It conducts a systematic literature review following the PRISMA guidelines, searching databases for relevant articles published from 2017-2022. The review analyzes 12 eligible articles and finds that factors beyond just BMI, such as genetics, physical activity, metabolic disorders, previous heart disease history, nutrition, fat distribution, and changes in BMI, can significantly impact the prognosis of heart disease in obese individuals. Importantly, the study shows that measures of fat distribution, like waist-to-height ratio, waist circumference, log-transformed body shape index (LBSIZ), and the ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT), are superior to BMI in predicting CVD risk among those with obesity. The key takeaway is that while obesity is strongly linked to CVD risk, BMI alone often fails to predict that risk accurately. Fat distribution measures may be a more effective tool for identifying obesity status and predicting associated CVD risk compared to relying solely on BMI.