Central obesity indices and the risk of heart disease

Central obesity indices and the risk of heart disease, type 2 diabetes mellitus, and stroke: findings from a Chinese prospective cohort. Download PDF Abstract Obesity is a major risk factor for cardiometabolic disease, but the relative value of different anthropometric indices for risk remains uncertain. Body mass index (BMI) is widely used but does not reflect fat distribution, whereas central obesity measures may better capture visceral adiposity.

Their associations with major cardiometabolic diseases have not been comprehensively compared in Asian populations. Using data from a large prospective cohort of Chinese adults, we compared the associations of BMI, waist circumference (WC), waist-to-height ratio (WHtR), body roundness index (BRI), a body shape index (ABSI), and weight-adjusted waist index (WWI) with incident heart disease, type 2 diabetes mellitus (T2DM), and stroke. Machine learning–assisted effect estimates were derived using a doubly solid Double Machine Learning framework and were complemented by Cox proportional hazards models.

Restricted cubic spline analyses were used to explore nonlinear exposure–response relationships. Sensitivity analyses were conducted to assess the robustness of the findings. Most indices were positively associated with the outcomes, although the strength and statistical significance of the associations varied by index, outcome, and adjustment model.

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