Validation of anthropometric indices of adiposity against whole-body magnetic resonance imaging--a study within the German European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts

Jasmine Neamat-Allah, Diana Wald, Anika Hüsing, Birgit Teucher, Andrea Wendt, Stefan Delorme, Julien Dinkel, Matthaeus Vigl, Manuela M Bergmann, Silke Feller, Johannes Hierholzer, Heiner Boeing, Rudolf Kaaks, Jasmine Neamat-Allah, Diana Wald, Anika Hüsing, Birgit Teucher, Andrea Wendt, Stefan Delorme, Julien Dinkel, Matthaeus Vigl, Manuela M Bergmann, Silke Feller, Johannes Hierholzer, Heiner Boeing, Rudolf Kaaks

Abstract

Background: In epidemiological studies, measures of body fat generally are obtained through anthropometric indices such as the body mass index (BMI), waist (WC), and hip circumferences (HC). Such indices, however, can only provide estimates of a person's true body fat content, overall or by adipose compartment, and may have limited accuracy, especially for the visceral adipose compartment (VAT).

Objective: To determine the extent to which different body adipose tissue compartments are adequately predicted by anthropometry, and to identify anthropometric measures alone, or in combination to predict overall adiposity and specific adipose tissue compartments, independently of age and body size (height).

Methods: In a sub-study of 1,192 participants of the German EPIC (European Prospective Investigation into Cancer and Nutrition) cohorts, whole-body MRI was performed to determine adipose and muscle tissue compartments. Additional anthropometric measurements of BMI, WC and HC were taken.

Results: After adjusting for age and height, BMI, WC and HC were better predictors of total body volume (TBV), total adipose tissue (TAT) and subcutaneous adipose tissue (SAT) than for VAT, coronary adipose tissue (CAT) and skeletal muscle tissue (SMT). In both sexes, BMI was the best predictor for TBV (men: r = 0.72 [0.68-0.76], women: r = 0.80 [0.77-0.83]) and SMT (men: r = 0.52 [0.45-0.57], women: r = 0.48 [0.41-0.54]). WC was the best predictor variable for TAT (r = 0.48 [0.41-0.54]), VAT (r = 0.44 [0.37-0.50]) and CAT (r = 0.34 [0.26-0.41]) (men), and for VAT (r = 0.42 [0.35-0.49]) and CAT (r = 0.29 [0.22-0.37]) (women). BMI was the best predictor for TAT (r = 0.49 [0.43-0.55]) (women). HC was the best predictor for SAT (men (r = 0.39 [0.32-0.45]) and women (r = 0.52 [0.46-0.58])).

Conclusions: Especially the volumes of internal body fat compartments are poorly predicted by anthropometry. A possible implication may be that associations of chronic disease risks with the sizes of internal body fat as measured by BMI, WC and HC may be strongly underestimated.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. a–f. Illustration of different MRI…
Figure 1. a–f. Illustration of different MRI body compartments in the sub-study of the German EPIC cohorts.
Figure 2. Prediction of body compartments by…
Figure 2. Prediction of body compartments by anthropometric indices in multiple linear regression analyses (Men, n = 598).
Total model R2 for each body compartment and partial correlation coefficients (95% CI) for anthropometric indices. All variables were adjusted for age and height. TBV = Total body volume, TAT = total adipose tissue, SAT = subcutaneous adipose tissue, VAT = visceral adipose tissue, CAT = coronary adipose tissue, SMT = skeletal muscle tissue, BMI = body mass index, WC = waist circumference, HC = hip circumference. 1 Predictors included: BMI, WC, HC. All variables (predictors and outcome) adjusted by age and height with the residual method. 2Partial correlation coefficients (95% CI) are reported for predictor variables.
Figure 3. Prediction of body compartments by…
Figure 3. Prediction of body compartments by anthropometric indices in multiple linear regression analyses (Women, n = 594).
Total model R2 for each body compartment and partial correlation coefficients (95% CI) for anthropometric indices. All variables were adjusted for age and height. TBV = Total body volume, TAT = total adipose tissue, SAT = subcutaneous adipose tissue, VAT = visceral adipose tissue, CAT = coronary adipose tissue, SMT = skeletal muscle tissue, BMI = body mass index, WC = waist circumference, HC = hip circumference. 1 Predictors included: BMI, WC, HC. All variables (predictors and outcome) adjusted by age and height with the residual method. 2Partial correlation coefficients (95% CI) are reported for predictor variables.

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