What is the best anthropometry index to evaluate the risk of metabolic abnormalities in Chinese adults?

Abstract

Aims Obesity, defined by body mass index (BMI), is a heterogeneous condition with varying metabolic manifestations, and the best index for predicting metabolic abnormalities remains unclear. This study aimed to explore the most suitable anthropometry index for predicting metabolic abnormalities in Chinese adults. Methods A cross‐sectional study was conducted using the data obtained from 9517 Chinese adults who underwent physical examination, bioelectrical impedance analysis, and laboratory examinations between March 2018 and March 2022. Participants were further divided into eight subgroups according to age, BMI, and sex. Descriptive statistics were calculated, and the area under the receiver operating characteristic curve and Youden index values were calculated to identify the best predictor of metabolic abnormalities in Chinese adults. Results The waist‐to‐height ratio (WHtR) had the largest area under the curve for predicting metabolic abnormalities in men of any age and women aged 18–49 years. However, BMI showed the highest accuracy in predicting metabolic abnormalities in women aged 50 years and older. Based on the highest Youden index, the optimal WHtR threshold was 0.51 in women and 0.53 in men. Conclusions The WHtR was the most effective index for predicting metabolic abnormalities in most Chinese adults, whereas BMI showed a higher accuracy only in elderly women. This observation supports WHtR as a novel adiposity marker for screening metabolic abnormalities and shows value for public health practice.

Abdominal volume index, waist-to-height ratio, and waist circumference are optimal predictors of cardiometabolic abnormalities in a sample of Lebanese adults: A cross-sectional study

“…Of clinical importance, a WHtR of 0.5 is emerging as a cut-off for metabolic abnormalities among different ethnicities and even in nonoverweight/obese adults [36]. The value of a WHtR of 0.5 as a universal cut-off for screening for metabolic abnormalities is confirmed by the meta-analysis by Ashwell et al [37], and large epidemiological studies in several countries [38,39]. It has been hypothesized that WHtR is a more reliable predictor than WC alone given the genetic advantage of height on cardiometabolic risk whether it be due to genetics alone or the effect of intrauterine exposures during critical period of growth and development [37].…”

Development and evaluation of machine learning models and nomogram for the prediction of severe acute pancreatitis

“…And the cut‐off values of all these variables were obtained by ROC curves, with the values reaching the maximum AUC (Youden's index = sensitivity + specificity − 1). As described by Hu et al, 21 the ROC curve and Youden's index were also calculated to identify the best predictor of metabolic abnormalities in Chinese adults. The cut‐off values were as follows: CRP ≥ 95 mg/dL, white blood cell count (WBC) ≥ 16.5 × 10 9 L, neutrophil to lymphocyte ratio (NLR) ≥ 10, alanine aminotransferase (ALT) ≥ 61.5 U/L, aspartate aminotransferase (AST) ≥ 43.5 U/L, albumin (ALB) < 30 g/L, glucose (GLU) ≥ 9 mmol/L, blood urea nitrogen (BUN) > 20 mg/dL, calcium (CA) ≥ 2 mmol/L, high‐density lipoprotein (HDL) ≥ 0.7 mmol/L, pancreatic inflammation (PI) (yes vs. no), pancreatic necrosis (PN) (yes vs. no), and extrapancreatic complications (yes vs. no).…”