Why the study?
BMI cannot distinguish lean mass from fat, especially in older adults with sarcopenia, leaving unclear whether BMI or waist circumference better predicts myocardial infarction.
Do body mass index and waist circumference reliably predict the risk of incident myocardial infarction in adults over 75 years old?
Do body mass index and waist circumference reliably predict the risk of incident myocardial infarction in adults over 75 years old?
In adults over 75 years of age, waist circumference is a more appropriate indicator for predicting myocardial infarction risk than BMI, as higher BMI paradoxically correlated with lower MI risk while higher waist circumference correlated with higher MI risk.
Questions BMI utility for MI risk prediction in adults >75; leaves open whether WC improves stratification pending validation.
Background and Objectives: Body mass index (BMI) is widely used as a standard screening method for obesity and an indicator of related diseases. However, its inability to distinguish between lean body mass and body fat limits its utility. This limitation may be more prominent in older populations, wherein age-related sarcopenia and increased visceral fat due to the redistribution of adipose tissue may preclude a precise estimation of obesity. Many studies suggest that waist circumference (WC) is more strongly related to obesity-related diseases. There are also different opinions on whether the obesity paradox is real or a result of confusing interpretations. This study seeks to determine the association between myocardial infarction (MI), BMI, and WC in older adults and to determine if BMI and WC can reliably predict the risk of cardiovascular disease. Materials and Methods: We conducted a cohort study of older Korean adults aged over 75 years registered in the National Health Insurance System Senior database. Results: The results from the analysis using model 5, which was adjusted for each study variable, showed that the lower the BMI, the higher the hazard ratio (HR) of MI and vice versa. On the other hand, groups with lower than normal WC showed lower HR; even if it was higher, the difference was not statistically significant. Those with abdominal obesity tended to have an increased HR of MI. Conclusions: This study found that HR for MI has a negative relationship with BMI, whereas it has a positive relationship with WC. Furthermore, WC is a more appropriate indicator for predicting the risk of MI in the older population.
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Han et al. (2022) studied this question.
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