Anthropometric indices for predicting incident cardiovascular disease: a 13-year follow-up study in a Japanese...

To our knowledge, no previous study has compared the predictive capacity of various anthropometric indices of cardiovascular disease (CVD) risk in East Asians.

This study aimed to compare which anthropometric indices have a greater impact on CVD in the Japanese population.

Data from a health checkup program conducted by the Panasonic Corporation between 2008 and 2021, including 160,656 participants, were analyzed. The primary outcome was the incidence of 3-point major adverse cardiac events (MACEs), including cardiovascular death, nonfatal coronary artery disease, and nonfatal stroke. Cox proportional hazards models and time-dependent receiver operating characteristic (ROC) analyses were used to evaluate the associations between 5 anthropometric indices [body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), and waist-to-height ratio (WHtR)] and incident MACE, stratified by gender.

Multivariate analysis showed that all anthropometric indices were associated with incident MACE in males: BMI {hazard ratio (HR) per SD 1.15, [95% confidence interval (CI): 1.11, 1.18]}, WC [1.15, (1.12, 1.19)], ABSI [1.06, (1.02, 1.09)], BRI [1.16, (1.13, 1.20)], and WHtR [1.17, (1.13, 1.21)]. In females, no significant associations were found between any anthropometric indices and the incident MACE. Among males, the areas under the curve values for BRI and WHtR [both 0.608 (95% CI: 0.598, 0.618)] were higher than those for BMI [0.586 (5% CI: 0.576, 0.596)], WC [0.598 (95% CI: 0.588, 0.608)], and ABSI [0.563 (95% CI: 0.552, 0.573)], with the values for BRI and WHtR being identical. The optimal cut-off values for predicting CVD were 3.250 for BRI and 0.494 for WHtR.

BRI and WHtR were more significant predictors of incident CVD in Japanese males >13 y of follow-up than BMI, WC, and ABSI. The identified cutoffs may help improve risk stratification and support early preventive interventions to reduce cardiovascular disease risk.