Use of height3:waist circumference3 as an index for metabolic risk assessment?

Abstract

Current anthropometric indices for health risk assessment are indirect measures of total or visceral body fat mass that do not consider the inverse relationship of lean body mass to metabolic risk as well as the non-linear relationship between central obesity and insulin resistance.We examined a new anthropometric index that reflects the relationship of waist circumference (WC) as a risk factor to fat-free mass (FFM) as a protective parameter of body composition. In apopulation of 335 adults (191 females and 144 males; mean age 53 (sd 13·9) years) with ahigh prevalence of obesity (27%) and metabolic syndrome (30%) we derived FFM:WC3 from the best fit of the relationship with metabolic risk factors (plasma triacylglycerol levels and insulin resistance by homeostasis model assessment index). Because FFM is known to be proportional to the cube of height, FFM was subsequently replaced by height3 yielding height3:WC3 as an easily applicable anthropometric index. Significant inverse relationships of height3:WC3 to metabolic risk factorswere observed for both sexes. They slightly exceeded those of conventional anthropometric indicessuch as BMI, WC or WC:hip ratio in women but not in men. The exponential character of the denominator WC3 implies that at a given FFM with gradually increasing WC the increasein metabolic risk is lower than proportional. Further studies are needed to evaluate height3:WC3 as an anthropometric index for health risk assessment.