Key result
Newly estimated optimal cut-off values for BMI to predict cardiometabolic risk were lower than standard obesity thresholds (28.1 kg/m2 for men and 27.5 kg/m2 for women), with BMI demonstrating the highest predictive potential.
Why the study?
Because there are no agreed, optimal methods to quantify body fat, its clinical application is not deemed effective, warranting identification of optimal cut-off values for anthropometric indicators to evaluate cardiometabolic risk.
Do newly estimated cut-off values for anthropometric indicators based on body fat percentage improve the screening for cardiometabolic disorders in adults compared to standard obesity thresholds?
Cross-Sectional (n=4,735)
No
Do newly estimated cut-off values for anthropometric indicators based on body fat percentage improve the screening for cardiometabolic disorders in adults compared to standard obesity thresholds?
Effect estimate: AUC 0.915 (95% CI 0.902-0.929)
p-value: p=0.000001
Newly estimated, lower BMI cut-offs based on body fat percentage may improve the identification of cardiometabolic risk in adults, highlighting that significant risk exists even in patients currently classified as merely overweight.
Lower BMI cut-offs may flag cardiometabolic risk missed by current thresholds; leaves open prospective validation for screening use.
Excessive accumulation of body fat (BF) promotes obesity, whilst posing a significant health hazard. There being no agreed, optimal quantifying methods, application of BF variable in clinical practice is not deemed an effective assessment option. The study, involving 4,735 patients (33.6% men), aged 45-64, aimed to identify optimal cut-off values for anthropometric indicators of obesity to evaluate cardiometabolic risk. A minimum P-value approach was applied to calculate the cut-offs for BF%. Threshold values for body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height (WHTR) ratio, facilitating optimal differentiation of cardiometabolic risk, were based on BF%, expressed as a binary classifier. The newly estimated cut-off values for predicting cardiometabolic risk, based on BMI, were lower than the referential obesity thresholds, whereas the threshold values of WC, WHR, and WHTR were higher. Apart from dyslipidemia, the odds of cardiometabolic disorders were higher, when the anthropometric indicators under study exceeded the cut-off points in both sexes. The proposed cut-offs proved instrumental in predicting cardiometabolic risk, whilst highlighting diagnostic and clinical potential of BF%, whereas BMI boasted the highest predictive potential. Cardiometabolic risk also proved significantly higher even in the overweight patients.
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Macek et al. (2020) conducted a cross-sectional in Obesity and Cardiometabolic Disorders (n=4,735). Anthropometric indicators of obesity (BMI, WC, WHR, WHTR) vs. Standard obesity cut-offs was evaluated on Discriminative ability (AUC) of BMI for identifying at least one cardiometabolic risk factor in men (AUC 0.915, 95% CI 0.902-0.929, p=0.000001). Newly estimated optimal cut-off values for BMI to predict cardiometabolic risk were lower than standard obesity thresholds (28.1 kg/m2 for men and 27.5 kg/m2 for women), with BMI demonstrating the highest predictive potential.
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