Allometric body shape indices, type 2 diabetes and kidney function: A two-sample Mendelian randomization study.

AIM: To examine the association between body mass index (BMI)-independent allometric body shape indices and kidney function. MATERIALS AND METHODS: We performed a two-sample Mendelian randomization (MR) analysis, using summary statistics from UK Biobank, CKDGen and DIAGRAM. BMI-independent allometric body shape indices were: A Body Shape Index (ABSI), Waist-Hip Index (WHI) and Hip Index (HI). Kidney function outcomes were: urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate and blood urea nitrogen. Furthermore, we investigated type 2 diabetes (T2D) as a potential mediator on the pathway to albuminuria. The main analysis was inverse variance-weighted random-effects MR in participants of European ancestry. We also performed several sensitivity MR analyses. RESULTS: A 1-standard deviation (SD) increase in genetically predicted ABSI and WHI levels was associated with higher UACR (ß = 0.039 [95% confidence interval: 0.016, 0.063] log [UACR], P = 0.001 for ABSI, and ß = 0.028 [0.012, 0.044] log [UACR], P = 6 x 10-4 for WHI) in women, but not in men. Meanwhile, a 1-SD increase in genetically predicted HI was associated with lower UACR in women (ß = -0.021 [-0.041, 0.000] log [UACR], P = 0.05) and in men (ß = -0.026 [-0.058, 0.005] log [UACR], P = 0.10). Corresponding estimates in individuals with diabetes were substantially augmented. Risk of T2D increased for genetically high ABSI and WHI in women (P < 6 x 10-19 ) only, but decreased for genetically high HI in both sexes (P < 9 x 10-3 ). No other associations were observed. CONCLUSIONS: Genetically high HI was associated with decreased risk of albuminuria, mediated through decreased T2D risk in both sexes. Opposite associations applied to genetically high ABSI and WHI in women only.

Analysis of monthly average precipitation of Wadi Ouahrane basin in Algeria by using the ITRA, ITPAM, and TPS methods.

Precipitation is one of the most significant components for the basin's hydrological cycle. Numerous features of a basin's water circulation may be affected by the chronological, geographical, and seasonal fluctuation of precipitation. It could be an important factor that influences hydrometeorological phenomena including floods and droughts. In this research, the innovative trend risk analysis (ITRA), innovative trend pivot analysis (ITPAM), and trend polygon star (TPS) methodologies of visualizing precipitation data are used to detect precipitation changes at six stations in Algeria's Wadi Ouahrane basin from 1972 to 2018. ITRA graphs show the direction of the precipitation trend (increasing-decreasing) and the trend risk class. Disparities in the polygons generated by the arithmetic mean and standard deviation ITPAM graphs demonstrate variations in precipitation seasonally and in the seasonal precipitation trends (increasing or decreasing) between sites. The TPS maps depict monthly variations in precipitation and highlight the autumn and spring transitions between the dry and wet seasons.

What is the best anthropometric predictor for identifying higher risk for cardiovascular diseases in afro-descendant Brazilian women? A cross-sectional population-based study.

OBJECTIVES: Excessive adiposity is associated with cardiovascular disease (CVD). Anthropometric indices are useful in screening individuals at higher risk for these diseases. However, there are no studies that show which of these indices has the best discriminatory power among Afro-descendant Brazilian women. The objective of this study was to assess the accuracy of anthropometric indices in identifying risk factors for CVD in Afro-descendant Brazilian women and define the one most suitable for use under the operating conditions prevailing in Quilombola communities. METHODS: A household random sample of 1661 women descendants of African slaves were analyzed. The anthropometric predictors analyzed were waist circumference (WC), body mass index, waist-to-height ratio, conicity index (C-index), body shape index, and percentage of body fat (%BF; estimated by bioimpedance). The assessed risk factors for CVD were arterial hypertension, diabetes mellitus, and dyslipidemias (hypertriglyceridemia; hypercholesterolemia; low high-density lipoprotein). To identify the statistical significance between the differences in the areas under the ROC curves (AUC) obtained with the different predictors and outcomes, was used the Bonferroni test adjusted for multiple analyses by the Sidak method. RESULTS: The AUC obtained with WC was higher (p < .05) or similar (p > .05) to those obtained with the other predictors 29 times out of 30 possibilities (six predictors x five outcomes). Only the AUC obtained with C-index in identifying hypercholesterolemia was significantly higher than that with WC. CONCLUSION: Due to its accuracy and greater operational simplicity, WC was the most adequate predictor for identifying Afro-descendant women at greatest risk for CVD.

Hotter and drier climate made the Mediterranean Europe and Northern Africa region a shrubbier landscape.

A shift to higher temperatures has left the Mediterranean Europe and Northern Africa (MENA) region more vulnerable to drought and land degradation. We used MODIS LAI (leaf area index) and GPP (gross primary production) deficits, the differences between actual and historical-maximum values, to describe vegetation structural and functional changes and consequential landcover change in response to changing climate conditions during 2001-2019 in the area (20° W-45° E, 20° N-45° N). We found that 1) the vegetation responses varied significantly among eight landcover types with the decreasing importance: forests, savannas, a mosaic of cropland and natural vegetation (CNV), croplands, permanent wetlands, urban land, grasslands, and shrublands, each with distinctive yet overlapping signatures over the ranges of the climate conditions considered. 2) Forests, occupying the coolest and wettest niche, showed the strongest response to severe drought with a lag of 1-3 years and a legacy effect for 10 years. Shrubs, occupying the hottest and driest niche, were the most resilient under a hotter and drier climate. 3) The total areas of savannas and CNV increased by 394,994 and 404,592 km2, respectively, while that of forests decreased by 33,091 km2. Shrublands extended by 287,134 km2 while grasslands and croplands retreated by 490,644 and 225,263 km2. The area of wetlands increased by 49,192 km2, and that of urban land increased by 39,570 km2. A total of 57,649 km2 of barren land became vegetated over the years. Along with higher temperature and more extended period of drought, MENA has evolved towards a shrubbier landscape.

A body shape index (ABSI) reflects body composition changes in response to testosterone treatment in obese men.

BACKGROUND: Interventions such as testosterone treatment may change body composition and metabolic outcomes without substantial changes in weight and BMI. OBJECTIVES: Using testosterone treatment as a paradigm, we hypothesized that a body shape index (ABSI) reflects body composition changes more accurately than traditional markers, such as weight, BMI and waist circumference. INTERVENTION: Secondary analysis of a 56-week RCT in 100 dieting obese men with low-normal testosterone receiving testosterone treatment or placebo, and subsequent off-treatment follow-up. RESULTS: At the end of the trial period, ABSI-unlike weight, BMI or waist circumference-had significantly decreased in the treatment group, compared with placebo (mean adjusted difference -0.18 [95% CI: -0.32, -0.05] × 10-2 m11/6kg-2/3, overall P<0.001). Changes in ABSI during the active trial phase correlated with changes in fat mass (tau = 0.18, P = 0.02), and not with lean mass (tau = -0.11, P = 0.14), BMI (tau = 0.10, P = 0.17), or visceral fat (tau = 0.07, P = 0.37). ABSI baseline values were positively correlated with waist circumference (tau = 0.21, P = 0.002) and visceral fat (tau = 0.18, P = 0.009), correlated inversely with lean mass (tau = -0.21, P = 0.002), and were uncorrelated with BMI (tau = -0.10, P = 0.15) and fat mass (tau = 0.01, P = 0.83). Two years after cessation of treatment, ABSI again reflected body composition as the between-group differences in all parameters did not persist. CONCLUSIONS: A readily obtainable anthropomorphic measure, ABSI reflects the differential loss of fat mass mediated by testosterone in dieting obese men more closely than BMI or waist circumference. It may serve as a clinically useful marker to monitor body composition changes, particularly in response to interventions.

The predictive ability of ABSI compared to BMI for mortality and frailty among older adults.

Introduction: To study the utility of A Body Shape Index (ABSI) alongside body mass index (BMI) to predict mortality and frailty in an aging community population. Materials and methods: Participants (n = 1,580) were drawn from the first Israeli national health and nutrition survey of older adults ("Mabat Zahav") conducted from 2005 to 2006, constituting adults aged ≥65 years. Socio-demographic, clinical, behavioral, and psychosocial data were collected. Baseline weight, height, and waist circumference (WC) were measured and expressed as the allometric indices BMI (kg/m2) and ABSI, a BMI-independent measure of abdominal obesity [WC/(BMI2/3*m1/2)]. Mortality follow-up lasted through 2019. Frailty was assessed in 2017-2019 by the Fried Biological Phenotype in a sub-cohort of 554 survivors. Cox and logistic regression models assessed associations of BMI and ABSI with mortality and frailty. Results: At baseline, mean [SD] age was 74.5 [6.1] years, and 52.4% were women. The correlation between BMI and WC Z scores was 0.71, reduced to -0.11 for BMI and ABSI. Over a median follow-up of 13 years, 757 deaths occurred. The multivariable-adjusted hazard ratios (95% CIs) for mortality per standard deviation increase in BMI and ABSI were 1.07 (0.99;1.17) and 1.13 (1.05;1.21), respectively. Among participants assessed for frailty, 77 (14%) met the frailty criteria. After multivariable adjustment, the odds ratios (95% CIs) for frailty were 0.83 (0.69-1.01) for BMI and 1.55 (1.34-1.79) for ABSI. Discussion: In a nationwide cohort of older adults, ABSI was independently associated with mortality risk. Furthermore, ABSI, but not BMI, was a strong predictor of frailty.

Water limitation regulates positive feedback of increased ecosystem respiration.

Terrestrial ecosystem respiration increases exponentially with temperature, constituting a positive feedback loop accelerating global warming. However, the response of ecosystem respiration to temperature strongly depends on water availability, yet where and when the water effects are important, is presently poorly constrained, introducing uncertainties in climate-carbon cycle feedback projections. Here, we disentangle the effects of temperature and precipitation (a proxy for water availability) on ecosystem respiration by analysing eddy covariance CO2 flux measurements across 212 globally distributed sites. We reveal a threshold precipitation function, determined by the balance between precipitation and ecosystem water demand, which separates temperature-limited and water-limited respiration. Respiration is temperature limited for precipitation above that threshold function, whereas in drier areas water limitation reduces the temperature sensitivity of respiration and its positive feedback to global warming. If the trend of expansion of water-limited areas with warming climate over the last decades continues, the positive feedback of ecosystem respiration is likely to be weakened and counteracted by the increasing water limitation.

Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study.

AIM: To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness. METHODS: Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0. RESULTS: Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks. CONCLUSION: Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.

Diet Composition, Anthropometrics, and Mortality Risk.

While overeating is considered a cause of the obesity epidemic as quantified by body mass index (BMI), the association of diet with a body shape index (ABSI) and hip index (HI), which are transformations of waist and hip circumference that are independent of BMI and which predict mortality risk, is poorly known. We used data from the Atherosclerosis Risk in Communities (ARIC) study of about 15,000 middle-aged adults to investigate associations between macronutrient intake (energy, carbohydrate, protein, and fat, the latter two divided into plant and animal sources, all based on self-reported food frequency) with anthropometric indices (BMI, ABSI, and HI). We also analyzed the association of diet and anthropometrics with death rate during approximately 30 years of follow-up. High intake of energy and animal fat and protein was generally associated with higher ABSI and lower HI at baseline, as well as greater mortality hazard. BMI was also positively linked with animal fat and protein intake. In contrast, higher intake of carbohydrates and plant fat and protein was associated with lower ABSI and BMI, higher HI, and lower mortality hazard. For example, after adjustment for potential confounders, each standard deviation of additional plant fat intake (as a fraction of total energy) was associated with a 5% decrease in mortality rate, while animal fat intake was associated with a 5% mortality increase per standard deviation. The directions of the associations between diet and anthropometrics are consistent with those found between anthropometrics and mortality without reference to diet.

Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard.

Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999-2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and that adjustment for BMI and ABSI reduced these dependencies. Whole-body composition did not substantially improve mortality prediction compared to basic anthropometrics alone, but regional composition did, with high trunk fat-free mass and low limb fat-free mass both associated with elevated mortality risk. These findings illustrate how DEXA body composition could guide health assessment in conjunction with the more widely employed simple anthropometrics.

A Body Shape Index (ABSI) and Hip Index (HI) Adjust Waist and Hip Circumferences for Body Mass Index, But Only ABSI Predicts High Cardiovascular Risk in the Spanish Caucasian Population.

Background: Our aim in this study was to investigate if Hip index (HI) improves the identification of cardiovascular risk (CVR) beyond that achieved with either the waist-to-height ratio (WHtR) or body mass index (BMI)-adjusted waist circumference (A body shape index [ABSI]) in the Spanish Caucasian population. Methods: Three thousand eight hundred forty-four subjects (1754 males, response rate 75.8%) were included. Anthropometric indices (AIs) included were HI, ABSI, and WHtR. CVR was estimated using the Framingham, Systematic COronary Risk Evaluation (SCORE), and American College of Cardiology/American Heart Association (ACC/AHA) charts. Areas under the receiver operating characteristic curve (AUC) were obtained to evaluate the performance of AIs in detecting CVR. We also estimated the AIs' standardized Z-scores and compared them against the CVR. Results: AUC demonstrated that the best AI in males to estimate higher CVR according to Framingham and ACC/AHA charts was WHtR. In females, WHtR also achieved good performance and showed higher prediction capacity than the other AIs. After transforming to Z-scores, ABSI was the best linear predictor for CVR according to SCORE and ACC/AHA, although WHtR also proved to be good. HI did not associate with the measures of CVR. Conclusions: HI does not predict high CVR in the Spanish Caucasian Population. However, ABSI is directly and linearly related to high CVR, with a higher performance than WHtR when standardized and evaluated as a linear predictor.

A Body shape index significantly predicts MRI-defined abdominal adipose tissue depots in non-obese Asian Indians with type 2 diabetes mellitus.

INTRODUCTION: We aimed to determine the correlations of volumes of subcutaneous abdominal adipose tissue (SCAT) (anterior, posterior, superficial and deep), total SCAT, intraperitoneal adipose tissue, retroperitoneal abdominal adipose tissue (RPAT), total intra-abdominal adipose tissue (IAAT), pancreatic volume, liver span, total body fat (TBF) and truncal fat mass (TFM) with anthropometric indices, viz., A Body Shape Index (ABSI), Hip Index, their Z scores and Anthropometric Risk Index in non-obese (body mass index (BMI) <25 kg/m2) Asian Indians with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: Non-obese patients with T2DM (cases; n, 85) and BMI-matched, healthy subjects (controls; n, 38) underwent anthropometry, dual energy X ray absorptiometry (DXA) for estimation of TBF, TFM and 1.5 T MRI for estimation of volumes of abdominal adipose tissue depots, pancreas and liver span. Spearman's correlation analysis and Receiver Operator Characteristic curve analysis were applied. RESULTS: The Z score of ABSI (Z_ABSI) showed significantly positive correlation with volumes of all depots of abdominal SCAT, total IAAT and RPAT in cases. Area under the curve for Z_ABSI (0.87) showed higher sensitivity: 82.0 %, specificity: 81.5 %, at a predictive cut-off value of 0.49 for abdominal adiposity. CONCLUSION: In non-obese Asian Indians with T2DM, the Z_ABSI showed significant correlation with IAAT and SCAT and higher predictive accuracy for abdominal adiposity. HIGHLIGHTS OF THE STUDY: This is the first MRI-based study in the context of ABSI in non-obese (BMI <25 kg/m2) Asian Indians with T2DM. Findings indicate that Z_ABSI has high predictive accuracy for abdominal adiposity in non-obese Asian Indians. The Z_ABSI index showed significantly positive correlation with volumes of adipose tissue depots, viz., abdominal SCAT, total IAAT and RPAT in cases.

Association of Body Shape Index (ABSI) with Hand Grip Strength.

Hand grip is a leading measure of muscle strength and general health, yet its association with body shape is not well characterized. Here, we examine correlations between grip strength, a body shape index (ABSI), and body mass index (BMI) in the 2011-2014 United States National Health and Nutrition Examination Survey cohorts. Grip strength was found to correlate negatively with ABSI (though positively with BMI), suggesting that those with a more central body profile tend to be weaker than others with the same weight. Individuals with low grip strength, as well as those with high ABSI, were more likely to die during follow up, whereas there was no association of BMI with mortality hazard. Transforming the grip strength, ABSI, and BMI by taking their logarithm prior to standardization did not meaningfully change the associations seen. These findings suggest that combining anthropometrics (ABSI, BMI) with grip strength may better identify individual mortality hazard in research studies and clinical practice.

Use of vegetation health data for estimation of aus rice yield in bangladesh.

Rice is a vital staple crop for Bangladesh and surrounding countries, with interannual variation in yields depending on climatic conditions. We compared Bangladesh yield of aus rice, one of the main varieties grown, from official agricultural statistics with Vegetation Health (VH) Indices [Vegetation Condition Index (VCI), Temperature Condition Index (TCI) and Vegetation Health Index (VHI)] computed from Advanced Very High Resolution Radiometer (AVHRR) data covering a period of 15 years (1991-2005). A strong correlation was found between aus rice yield and VCI and VHI during the critical period of aus rice development that occurs during March-April (weeks 8-13 of the year), several months in advance of the rice harvest. Stepwise principal component regression (PCR) was used to construct a model to predict yield as a function of critical-period VHI. The model reduced the yield prediction error variance by 62% compared with a prediction of average yield for each year. Remote sensing is a valuable tool for estimating rice yields well in advance of harvest and at a low cost.

Can an Exercise-Based Educational and Motivational Intervention be Durably Effective in Changing Compliance to Physical Activity and Anthropometric Risk in People with Type 2 Diabetes? A Follow-Up Study.

AIMS: A nine-month motivational exercise-based intervention was previously offered to subjects with type 2 diabetes (T2D). A year after the end of the intervention, compliance to physical activity (PA) and anthropometric indices of participants were analyzed to evaluate the durability of its effects. METHODS: PA levels, expressed as total energy expenditure per week, were assessed with the International Physical Activity Questionnaire (IPAQ). Changes in Body Mass Index (BMI), A Body Shape Index (ABSI), Hip Index (HI) z-scores, the relative mortality risk related to each of these measures, and a combined Anthropometric Risk Index (ARI) were also evaluated. RESULTS: Of a total of the 52 subjects examined (67.9% males, mean age 61.8 ± 6.0), 46 (88.4%) were still sufficiently active as defined by IPAQ thresholds at follow-up. PA levels, anthropometric indices and related risks improved at follow-up in respect to the baseline and to the end of the intervention, although only PA levels, BMI and related measures, and ARI risk changed significantly. Habitual PA increased significantly after the intervention (p < 0.01) and this increase correlated with changes in BMI z-scores (r = -0.29, p = 0.04). BMI risk was significantly lower (p < 0.01) in participants still active at follow-up. CONCLUSIONS: This study testifies to the persistence of compliance to PA and health benefits of a combined exercise-based and motivational intervention in subjects with T2D.

Anthropometrics, Metabolic Syndrome, and Mortality Hazard.

Independent indices (height, body mass index, a body shape index, and hip index) derived from basic anthropometrics have been found to be powerful predictors of mortality hazard, especially when the attributable risks are summed over these indices to give an anthropometric risk index (ARI). The metabolic syndrome (MS) is defined based on the co-occurrence of anthropometric, clinical, and laboratory criteria and is also widely employed for evaluating disease risk. Here, we investigate correlations between ARI and MS in a general population sample, the United States Third National Health and Nutrition Examination Survey. Baseline values of ARI and MS were also evaluated for their association with mortality over approximately 20 years of follow-up. ARI was found to be positively correlated with each component of MS, suggesting connections between the two entities as measures of cardiometabolic risk. ARI and MS were both significant predictors of mortality hazard. Although the association of ARI with mortality hazard was stronger than that of MS, a combined model with both ARI and MS score as predictors improved predictive ability over either construct in isolation. We conclude that the combination of anthropometrics and clinical and laboratory measurements holds the potential to increase the effectiveness of risk assessment compared to using either anthropometrics or the current components of MS alone.

Untangling Waist Circumference and Hip Circumference from Body Mass Index with a Body Shape Index, Hip Index, and Anthropometric Risk Indicator.

Body mass index (BMI) corrects body weight for height and is well established for diagnosing overweight and obesity and correlating with many medical conditions. Waist circumference (WC) is used to diagnose abdominal obesity. However, the correlation of BMI and WC is high, around 0.9, making the use of BMI and WC in concert challenging. A body shape index (ABSI) is a new measure of risk associated with abdominal size. Derived in 2012, ABSI is analogous to BMI in that it normalizes WC for weight and height (and thus to BMI). A similar derivation led to hip index (HI), normalizing hip circumference for BMI. Hazard ratios (HRs) for univariate risk associations of the independent measures height, BMI, ABSI, and HI can be multiplied to give a combined HR, the anthropometric risk indicator (ARI). Compared to any one anthropometric factor, including BMI and WC, ARI more accurately estimates personalized mortality hazard. Published work on ABSI, HI, and ARI supports their association with many aspects of health, including cardiometabolic conditions related to the metabolic syndrome.

ABSI (A Body Shape Index) and ARI (Anthropometric Risk Indicator) in Bariatric Surgery. First Application on a Bariatric Cohort and Possible Clinical Use.

BACKGROUND: BMI (body mass index) is used to identify candidates for bariatric surgery, with a criterion of BMI ≥ 40. For lesser degrees of obesity, BMI 35-39.9, comorbidities are also considered. A Body Shape Index (ABSI) was derived to correct WC (waist circumference) for BMI and height. ABSI has been shown to be a linear predictor of long-term mortality across the range of BMI. Anthropometric risk indicator (ARI) combines the complementary contributions of BMI and ABSI and further improves mortality hazard prediction. We report for the first time ABSI and ARI for a bariatric surgical cohort at baseline and with 3-year follow-up. METHODS: ABSI and BMI were calculated for 101 subjects from our bariatric surgery center database at baseline and after 3 years of follow-up. Raw values for BMI and ABSI were converted to Z scores and ARI values based on sex- and age-specific normals and risk associations from the National Health and Nutrition Examination Survey (NHANES) III sample of the US general population. RESULTS: Baseline scores for the anthropometric variables BMI and ABSI and the corresponding ARI were all higher than for the NHANES population sample. At 3-year post surgery, all three measures decreased significantly. While baseline BMI did not predict the change in mortality risk by ARI, baseline ABSI did (r = - 0.73), as did baseline ARI (r = - 0.94). CONCLUSION: Sleeve gastrectomy lowers ABSI and the associated mortality risk estimated from population studies after 3 years of follow-up. Considering our results, bariatric surgical candidates with BMI in the range of 35 to 39.9 with an increased ABSI-related mortality risk may have considerable survival benefit from bariatric surgery, even in the absence of qualifying comorbidities. TRIAL REGISTRATION NUMBER: 2814.

Relationship between "a body shape index (ABSI)" and body composition in obese patients with type 2 diabetes.

BACKGROUND: Obesity is known to be related to the development of type 2 diabetes mellitus (T2D). The most commonly used anthropometric indicator (body mass index [BMI]) presents several limitations such as the lack of possibility to distinguish adipose tissue distribution. Thus, this study examines the suitability of a body shape index (ABSI) for prediction of body composition and sarcopenic obesity in obese or overweight T2D subjects. METHODS: Cross-sectional study in 199 overweight/obese T2D adults. Anthropometric (BMI, ABSI) and body composition (fat mass [FM], fat-free mass [FFM], fat mass index [FMI] and fat-free mass index, and the ratio FM/FFM as an index of sarcopenic obesity) data was collected, as well as metabolic parameters (glycated haemoglobin [HbA1c], mean blood glucose, fasting plasma glucose [FPG], high-density-lipoprotein cholesterol [HDL], low-density-lipoprotein cholesterol, total cholesterol, and triglycerides [TG] levels; the ratio TG/HDL was also calculated as a surrogate marker for insulin resistance). RESULTS: ABSI was significantly associated with age and waist circumference. It showed a statistically significant correlation with BMI exclusively in women. Regarding body composition, in men, ABSI was associated with FM (%), while in women it was associated with both FM and FFM. Both males and females groups with high ABSI scores were significantly older (men: 59.3 ± 10.8 vs 54.6 ± 10.1, p ≤ 0.05; women: 65.1 ± 9.8 vs 58.1 ± 13.3, p ≤ 0.005) and showed lower FFM values (men: 62.3 ± 9.0 vs 66.2 ± 9.3, p ≤ 0.05; women: 48.7 ± 5.6 vs 54.5 ± 8.9, p ≤ 0.001) compared with low-ABSI groups. Multiple linear regression revealed that ABSI independently predict FMI and the FM/FFM ratio in women. Sarcopenic obesity was identified in 70 (36.5%) individuals according to the FM/FFM ratio. The AUROC of ABSI was 63.1% (95% CI 54.6-71.6%; p = 0.003) and an ABSI value of 0.083 m11/6 kg-2/3 was the optimal threshold in discriminating patients with sarcopenic obesity (sensitivity: 48%, specificity: 73%). Moreover, a significant association between ABSI and FPG was found in men. CONCLUSIONS: ABSI could be useful to identify visceral and sarcopenic obesity in overweight/obese adults with T2D, adding some relevant clinical information to traditional anthropometric measures.

The association between a body shape index and cardiovascular risk in overweight and obese children and adolescents.

A Body Shape Index (ABSI) and normalized hip circumference (Hip Index, HI) have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2-18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and its components, transaminases, fat mass % detected by bioelectrical impedance analysis) and obesity-related conditions (including hepatic steatosis and metabolic syndrome). We recruited 217 patients (114 males), mean age 11.3 years. Multivariate linear regression showed a significant association of ABSI z score with 10 out of 15 risk markers expressed as continuous variables, while BMI z score showed a significant correlation with 9 and HI only with 1. In multivariate logistic regression to predict occurrence of obesity-related conditions and above-threshold values of risk factors, BMI z score was significantly correlated to 7 out of 12, ABSI to 5, and HI to 1. Overall, ABSI is an independent anthropometric index that was significantly associated with cardiometabolic risk markers in a pediatric population affected by overweight and obesity.