Obesity vs. Whole-body-fat and myocardial infarction risk prediction. Body fat percentageis better indicator / Obesidad vs. grasa corporal total y predicción de riesgo de infarto. El porcentaje de grasa corporal es mejor indicador

ABSTRACT

OBJECTIVE: Our aim was to realize an anthropometric analysis to identify both the association and plausibility of measurements and indicators of general obesity and whole-body fat on the risk prediction for myocardial infarction (MI) in men. MATERIAL AND METHOD: A case-control study in 244 European men aged 30-74 years was conducted. We measured weight, height, waist and hip perimeters and skinfolds: triceps, subscapular and supraspinale, according to standardized protocols. We calculated the areas under the ROC curves, the odds ratios and correlations for indicators. RESULTS: Body mass index (BMI) [AUC: 0.687, 95% CI (0.619-0.715); OR: 3.5]. Waist circumference (WC) [AUC: 0.742, 95% CI (0.679-0.805); OR: 5.9]. Waist-to-height ratio (WHtR) [AUC: 0.780, 95% CI (0.721-0.839); OR: 8.4]. Endomorphy [AUC: 0.721, 95% CI (0.656-0.785); OR: 2.4]. Body fat percentage (%BF) [AUC: 0.774, 95% CI (0.714-0.834); OR: 10.2]. Lean body mass (LBM) [AUC: 0.490, 95% CI (0.413-0.568); OR: 1]. BMI correlated with %BF (0.84), endomorphy (0.80), WC (0.69), WHtR (0.72) and LBM (0.65). WHtR correlated with WC (0.97), %BF (0.92), endomorphy (0.62) and LBM (0.32). %BF correlated with WC (0.86) and endomorphy (0.78). The correlations between WHtR and body fat-associated indicators were strong (all r ≥ 0.62, p < 0.001). CONCLUSIONS: In MI men, body fat-associated indicators show different discriminative ability. BMI-defined obesity presents moderate discrimination and anthropometric association bias that do not lent support their suitability as risk predictor. Abdo-minal adiposity and whole-body fat percentage show the highest discriminative abilities and robust anthropometric reasons related with the true biological risk. We defend the use of WHtR as concept of risk volume and individual visceral adiposity for the early identification of adult men at risk of myocardial infarction