A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort

Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 par...

Full description

Bibliographic Details
Main Authors: Christakoudi, S, Tsilidis, KK, Muller, DC, Yin Tong
Format: Journal article
Language:English
Published: Springer Nature 2020
_version_ 1797095731972014080
author Christakoudi, S
Tsilidis, KK
Muller, DC
Yin Tong
author_facet Christakoudi, S
Tsilidis, KK
Muller, DC
Yin Tong
author_sort Christakoudi, S
collection OXFORD
description Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m2) or obese (BMI ≥ 30 kg/m2) categories, while the highest quartile of ABSI separated 18–39% of the individuals within each BMI category, which had 22–55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.
first_indexed 2024-03-07T04:32:06Z
format Journal article
id oxford-uuid:ceabefd5-a14d-4c4e-8ca7-6e103f855a64
institution University of Oxford
language English
last_indexed 2024-03-07T04:32:06Z
publishDate 2020
publisher Springer Nature
record_format dspace
spelling oxford-uuid:ceabefd5-a14d-4c4e-8ca7-6e103f855a642022-03-27T07:37:16ZA Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohortJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ceabefd5-a14d-4c4e-8ca7-6e103f855a64EnglishSymplectic ElementsSpringer Nature2020Christakoudi, STsilidis, KKMuller, DCYin TongAbdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m2) or obese (BMI ≥ 30 kg/m2) categories, while the highest quartile of ABSI separated 18–39% of the individuals within each BMI category, which had 22–55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.
spellingShingle Christakoudi, S
Tsilidis, KK
Muller, DC
Yin Tong
A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
title A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
title_full A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
title_fullStr A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
title_full_unstemmed A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
title_short A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
title_sort body shape index absi achieves better mortality risk stratification than alternative indices of abdominal obesity results from a large european cohort
work_keys_str_mv AT christakoudis abodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT tsilidiskk abodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT mullerdc abodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT yintong abodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT christakoudis bodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT tsilidiskk bodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT mullerdc bodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort
AT yintong bodyshapeindexabsiachievesbettermortalityriskstratificationthanalternativeindicesofabdominalobesityresultsfromalargeeuropeancohort