From the Journals

BMI compares favorably with body scanning for ID of cardiometabolic traits

View on the News

Despite simplicity, BMI useful in the young

This study reinforces fatness, quantified by body mass index, as the key modifiable factor for maintaining healthy metabolism in young people, according to Ville-Petteri Mäkinen, ScD.

“The good news is that a single BMI measurement may be enough to capture the same essential information as a detailed body scan and serial measurements,” Dr. Mäkinen wrote in an accompanying editorial.

One other important take-home message of the study is that fat gain is not beneficial in any body region; that finding is important with respect to changes in BMI and fat mass index observed in the second decade of life that were associated with cardiometabolic risk factors in the late teens, he noted.

However, the broader take-home message for society is that children are being exposed to an “adverse metabolic milieu” that predicts cardiovascular disease in adulthood, according to Dr. Mäkinen.

“Childhood obesity must not be seen as a phase that passes but as a looming public health crisis that needs to be addressed by all of us,” he concluded.

Dr. Mäkinen is with the South Australian Health and Medical Research Institute, Adelaide. He had no relationships relevant to the contents of his editorial (J Am College Cardiol. 2018 Dec 18;74[24]3155-7).



Although body mass index is criticized for not distinguishing fat from lean mass, its ability to detect subclinical cardiometabolic abnormalities was on par with more sophisticated body scanning technology, according a recent analysis.

BMI and dual-energy x-ray absorptiometry (DXA) had similar associations with cardiometabolic traits associated with coronary heart disease in individuals evaluated at 10 and 18 years of age in a population-based birth cohort study, the study investigators said.

Changes over time in BMI and DXA also were strongly associated with changes in blood pressure, cholesterol, and other markers, according to Joshua A. Bell, PhD, of MRC Integrative Epidemiology Unit, University of Bristol, England, and his coinvestigators.

“Altogether, the results support abdominal fatness as a primary driver of cardiometabolic dysfunction and BMI as a useful tool for detecting its effects,” Dr. Bell and his colleagues said in a report on the study appearing in the Journal of the American College of Cardiology.

In their analysis, Dr. Bell and coinvestigators used Pearson correlation coefficients to compare BMI and total and regional fat indexes from DXA in offspring participants from ALSPAC, (the Avon Longitudinal Study of Parents and Children), in which BMI and DXA measurements were collected at 10 and 18 years of age.

Researchers identified a total of 2,840 participants with at least one measurement at each of those time points. The mean BMI was 17.5 kg/m2 at 10 years of age and 22.7 kg/m2 at 18 years of age, with greater than 10% of participants classified as obese at each of those time points.

High BMI and high total fat mass index were similarly associated with a variety of cardiometabolic traits, including systolic and diastolic blood pressure, higher low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) cholesterol levels and lower high-density lipoprotein (HDL) cholesterol levels, and more inflammation, investigators found.

BMI was strongly correlated with DXA total and regional fat indexes at 10 years of age, and again at 18 years of age, they reported.

Moreover, gains in BMI from 10 to 18 years of age were strongly associated with higher blood pressure, higher LDL and VLDL cholesterol, lower HDL cholesterol, and other cardiometabolic traits, while associations between DXA measurements and those traits closely tracked those of BMI in pattern and magnitude, investigators added.

Fatness is most often measured in populations using BMI, and causal analyses suggest linkage between higher BMI and coronary heart disease and its intermediates, including blood pressure, LDL and remnant cholesterol, and glucose; despite that, BMI is often disparaged as a tool for assessing cardiometabolic abnormalities because it does not distinguish fat from lean mass and cannot quantify fat distribution, investigators said.

However, based on results of this analysis, it is reasonable to depend on BMI to indirectly measure body and abdominal fatness in future studies, they said in their report.

Dr. Bell and his colleagues reported that they had no relationships relevant to the study publication.

SOURCE: Bell JA et al. J Am Coll Cardiol. 2018 Dec 18;72(24):3142-54.

Recommended Reading

AHA: Statins associated with high degree of safety
MDedge Cardiology
Obesity meds used by just over half of pediatric obesity programs
MDedge Cardiology
AHA statement on statin risks, app that diagnoses STEMI, and more
MDedge Cardiology
Heavy drinkers have a harder time keeping the weight off
MDedge Cardiology
New diabetes guidelines downgrade insulin as first-line injectable treatment
MDedge Cardiology