Sex and race/ethnicity specific reference predictive equations for abdominal adiposity indices using anthropometry in US adults.

BACKGROUND AND AIMS: Abdominal adiposity indices have stronger associations with cardiometabolic risk factors compared to anthropometric measures but are rarely used in large scale studies due to the cost and efficiency. The aim of this study is to establish sex and race/ethnicity specific reference equations using anthropometric measures. METHODS AND RESULTS: A secondary data analysis (n = 6589) of healthy adults was conducted using data from National Health and Nutrition Examination Survey 2011-2018. Variables included in the analyses were anthropometric measures (height; weight; waist circumference, WC) and abdominal adiposity indices (android percent fat; android to gynoid ratio, A/G ratio; visceral adipose tissue area, VATA; visceral to subcutaneous adipose area ratio, VSR). Multivariable prediction models were developed using quantile regression. Bland-Altman was used for external validation of prediction models. Reference equations to estimate android percent fat, A/G ratio, VATA and VSR from anthropometric measurements were developed using a randomly selected subsample of 4613. These reference equations for four abdominal adiposity indices were then cross-validated in the remaining subsample of 1976. The measured and predicted android percent fat, A/G ratio, VATA and VSR were not statistically different (p > 0.05) except for the A/G ratio in Asian males and VSR in White females. The results of Bland-Altman further revealed that ≥93% of predicted abdominal adiposity indices fell within the limits of agreement (±1.96 standard deviation). CONCLUSION: The sex and race/ethnicity specific reference equations for abdominal adiposity indices established using anthropometrics in the present study have strong predictive ability in US healthy adults.

The Sex and Race/Ethnicity-Specific Relationships of Abdominal Fat Distribution and Anthropometric Indices in US Adults.

The purpose of this study was to examine demographic-specific relationships between direct abdominal fat measures and anthropometric indices. A cross-sectional study was conducted utilizing abdominal fat measures (visceral fat area, VFA; visceral to subcutaneous adipose area ratio, VSR) and anthropometrics (body mass index, BMI; waist circumference, WC) data from the 2011-2018 National Health and Nutrition Examination Survey. Linear or polynomial linear regression models were used to examine the relationships of abdominal fat measures to anthropometrics with adjustment for demographics. The results revealed that while VFA was linearly related to BMI and WC across all demographics (p < 0.001), the relationships between VSR and both BMI and WC were concave in men and convex in women. The relationships between VFA, VSR, and BMI, WC varied by sex and race/ethnicity. In conclusion, increasing BMI and WC were linearly associated with increased VFA, but their relationships with VSR were nonlinear and differed by sex.

High visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after surgery for colorectal cancer.

PURPOSE: Risks for postoperative small bowel obstruction have been demonstrated in several reports, most of which indicated male sex was a risk factor, but with the reason remaining unknown. We tested the hypothesis that it could be because males have more visceral fat than females. This prospective observational study aims to examine risks of early postoperative small bowel obstruction (EPSBO) after colorectal cancer surgery and the association between visceral to subcutaneous fat area ratio (V/S ratio) and EPSBO. METHODS: Four hundred and seventy-four patients who underwent colectomy for colorectal cancer in our hospital were enrolled in this study. The influence of several factors including V/S ratio on the development of EPSBO was analyzed. RESULTS: Thirty-one of the 474 patients (6.5%) developed EPSBO. EPSBO occurred more frequently in males (p = 0.03) and cases who developed postoperative anastomotic leakage (p < 0.001) or wound infection (p = 0.02). Higher V/S ratio was strongly related to male sex (p < 0.001). Multivariate analysis revealed higher V/S ratio (OR 2.25; p = 0.049) and anastomotic leakage (OR 5.86; p < 0.001) were independent risk factors for EPSBO. CONCLUSION: Higher V/S ratio was significantly related to EPSBO, suggesting that one of the reasons EPSBO was more likely to occur in males because they have more visceral fat than females. Preoperative identification of this risk factor could help us watch out for this potential complication.