肥満と減量療法のジャーナル

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Expansion of Waist Circumference in Medical Literature: Potential Clinical Application of a Body Shape Index

Nir Y Krakauer and Jesse C Krakauer

Background: Body mass index (BMI) has become the main indicator of obesity. Due to the limitations of BMI in identifying individuals with obesity-related morbidities, risk assessment has broadened to include other biometric measures, especially waist circumference (WC). Here, we present a brief survey of the increasing medical application of WC and related measures, including waist hip ratio (WHR) and waist height ratio (WHtR), with the goal of motivating the new Body Shape Index (ABSI), which adjusts WC for BMI, and providing guidance for the application of ABSI in medical research. Methods and findings: We searched Medline for mentions of obesity, BMI, WC, and related measures including ABSI. We find that BMI has become an almost universally used indicator for obesity since the early 1990s, but WC is increasingly employed as a supplementary indicator. We show that whereas fixed WC cutoffs are strongly correlated with BMI thresholds, ABSI values are distributed nearly equally across BMI categories, so that ABSI may be a better candidate for providing a biometric measure of wide clinical applicability that supplements BMI in assessing obesity and body composition. There is nascent interest in ABSI, and several publications have applied the measure. However, most do not appear to have adjusted for gender and age, both of which significantly impact ABSI. Conclusions: Various simple measures of obesity and body dimensions have been increasingly utilized in recent years. ABSI holds potential to improve clinical assessment beyond the measures now commonly used. Comparisons of anthropometric indices should employ consistent methodology, including adjustment for known covariates such as age and sex.