Objective To evaluate how body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio reflect visceral adipose tissue as measured by dual-energy X-ray absorptiometry and how these associations differ by sex and age in a Qatari adult population. Methods In this cross-sectional study of 5897 Qatari adults aged 18–88 years from the Qatar BioBank, we assessed the correlation between anthropometric indices and dual-energy X-ray absorptiometry–derived visceral adipose tissue percentage. Analyses included sex-stratified Spearman’s correlations and linear regression models adjusted for age. Model performance was assessed using standardized beta coefficients, R 2 , adjusted R 2 , Akaike Information Criterion, and Bayesian Information Criterion. Results Among females, waist circumference and waist-to-height ratio had the strongest correlations with visceral adipose tissue ( r = 0.70), followed by waist-to-hip ratio ( r = 0.68), whereas body mass index showed a moderate correlation with visceral adipose tissue ( r = 0.54). Among males, waist-to-hip ratio showed the highest correlation with visceral adipose tissue ( r = 0.71). Regression analyses confirmed waist-to-hip ratio as the strongest predictor in males and waist circumference as the strongest in females. Interaction models showed that associations between central adiposity indices and visceral adipose tissue strengthened with age. Conclusion Anthropometric indices reflecting central adiposity, waist-to-hip ratio, waist circumference, and waist-to-height ratio outperformed body mass index in predicting visceral adipose tissue in a sex- and age-specific manner. These findings may support the clinical utility of incorporating waist-based measures for visceral adipose tissue risk assessment.
Ajeen et al. (Mon,) studied this question.