Diabetes Metab J.  2019 Oct;43(5):675-682. 10.4093/dmj.2018.0169.

The Association between Z-Score of Log-Transformed A Body Shape Index and Cardiovascular Disease in Korea

• Chung W
• Park JH
• Chung HS
• Yu JM
• Moon S
• Kim DS

• KMID: 2460960
• DOI: http://doi.org/10.4093/dmj.2018.0169

Abstract

BACKGROUND
In order to overcome the limitations of body mass index (BMI) and waist circumference (WC), the z-score of the log-transformed A Body Shape Index (LBSIZ) has recently been introduced. In this study, we analyzed the relationship between the LBSIZ and cardiovascular disease (CVD) in a Korean representative sample.
METHODS
Data were collected from the Korea National Health and Nutrition Examination VI to V. The association between CVD and obesity indices was analyzed using a receiver operating characteristic curve. The cut-off value for the LBSIZ was estimated using the Youden index, and the odds ratio (OR) for CVD was determined via multivariate logistic regression analysis. ORs according to the LBSIZ value were analyzed using restricted cubic spline regression plots.
RESULTS
A total of 31,227 Korean healthy adults were analyzed. Area under the curve (AUC) of LBSIZ against CVD was 0.686 (95% confidence interval [CI], 0.671 to 0.702), which was significantly higher than the AUC of BMI (0.583; 95% CI, 0.567 to 0.599) or WC (0.646; 95% CI, 0.631 to 0.661) (P<0.001). Similar results were observed for stroke and coronary artery diseases. The cut-off value for the LBSIZ was 0.35 (sensitivity, 64.5%; specificity, 64%; OR, 1.29, 95% CI, 1.12 to 1.49). Under restricted cubic spline regression, LBSIZ demonstrated that OR started to increase past the median value.
CONCLUSION
The findings of this study suggest that the LBSIZ might be more strongly associated with CVD risks compared to BMI or WC. These outcomes would be helpful for CVD risk assessment in clinical settings, especially the cut-off value of the LBSIZ suggested in this study.

Keyword

Body composition; Body mass index; Cardiovascular diseases; Obesity; Waist circumference

MeSH Terms

Adult
Area Under Curve
Body Composition
Body Mass Index
Cardiovascular Diseases*
Coronary Artery Disease
Humans
Korea*
Logistic Models
Obesity
Odds Ratio
Risk Assessment
ROC Curve
Sensitivity and Specificity
Stroke
Waist Circumference

Figure

• 

  Fig. 1 Receiver operating characteristics curves for cardiovascular disease (CVD) by obesity parameters. (A) Total CVD. (B) Stroke. (C) Coronary artery disease. LBSIZ, z-score of the log-transformed A Body Shape Index; WC, waist circumference; BMI, body mass index; AUC, area under the curve.

• 

  Fig. 2 The odds ratio for cardiovascular disease according to z-score of the log-transformed A Body Shape Index (LBSIZ) value. Adjusted for age, sex, smoking, hypertension, diabetes mellitus, and dyslipidemia.

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