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Is BMI Good Enough to Measure Visceral Adiposity?

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> Dr. Gupta reports no financial relationships relevant to this field of study

SOURCE : Nazare JA, et al. Usefulness of measuring both body mass index and waist circumference for the estimation of visceral adiposity and related cardiometabolic risk profile (from the INSPIRE ME IAA Study). Am J Cardiol 2015;115:307-315.

Worldwide, the prevalence of obesity has reached epidemic proportions. This epidemic is not simply a consequence of poor diet or sedentary lifestyles, but is a complex, multifaceted state in which environmental, biological, and genetic factors all play essential roles. Increased body mass index (BMI) is associated with higher all-cause mortality compared with normal weight individuals, as well as mortality from cardiovascular disease. Abdominal adiposity is recognized to be associated with a number of conditions leading to increased cardiometabolic risk (CMR). Studies have demonstrated that measuring the indices of abdominal adiposity, such as waist-to-hip ratio (WHR) and waist circumference (WC), may be superior to BMI in detecting CMR in both sexes. 1 Measuring WC is a simple procedure requiring a tape measure. However, researchers do not completely agree and have questioned the clinical relevance of measuring WC instead of BMI to assess cardiovascular disease risk, since both BMI and WC have been found to be highly correlated and each can independently predict CMR. 2 When conducting assessments of central adiposity, directly assessing visceral adiposity tissue (VAT) by computed tomography allows more accurate evaluation since VAT is more metabolically active than other adipose tissue sites and appears to contribute to many metabolic abnormalities associated with weight gain.

In their study, Nazare et al evaluated the relevance of adding WC to BMI for the estimation of VAT and CMR. Between 2006 and 2008, 297 physicians recruited 4504 patients from 29 countries. Final analysis included data from 4109 patients. Researchers measured both BMI and WC...