Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan.
Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan.
Obes Facts. 2022;15(2):160-169. doi: 10.1159/000520418. Epub 2022 Jan 10.
Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with "A Body Shape Index (ABSI)," an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI).
A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0.
CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = -0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate <60 mL/min/1.73 m2. Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI.
DISCUSSION/CONCLUSION: Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.
虽然腰围（WC）不一定能反映内脏肥胖，但作为代谢综合征（MetS）诊断的风险因素，腹部肥胖用 WC 来评估。本横断面研究旨在明确用腹部肥胖指数“体脂肪分布指数（ABSI）”代替 MetS 诊断中的 WC，是否能检测到心血管脚踝血管指数（CAVI）评估的动脉僵硬个体。
对 46872 名日本城市居民（中位年龄 40 岁）进行了回顾性横断面研究，这些人都接受了健康筛查。排除标准为当前治疗和心血管疾病（CVD）病史。使用日本、国际糖尿病联盟和 NCEP-ATPIII 标准来诊断 MetS。高 CAVI 定义为 CAVI≥9.0。
CAVI 与 ABSI 呈正相关（β=0.127），与 WC 呈负相关（β=-0.186），独立于年龄、性别、收缩压、空腹血糖和高密度脂蛋白胆固醇。接受者操作特征（ROC）分析显示，ABSI 对高 CAVI 的贡献更强（ROC 曲线下面积 [AUC] = 0.730），优于 WC（AUC = 0.595）和体重指数（AUC = 0.520）。根据高 CAVI 和估计肾小球滤过率<60 mL/min/1.73 m2 的 ROC 分析结果，将 ABSI≥0.080 定义为腹部肥胖。逻辑回归分析显示，用 ABSI≥0.080 代替 MetS 诊断中的高 WC，可增强对高 CAVI 患者的检测。
讨论/结论：使用 ABSI 可以检测到动脉僵硬的患者，这可能有助于有效分层 CVD 风险。需要进一步研究来确认使用 ABSI 诊断 MetS 是否可以预测 CVD 的发病率和死亡率。
