Body mass index (BMI) is an imperfect measure of adiposity. A novel index has been validated (Body Adiposity Index, BAI)( Reference Bergman, Stefanovski, Buchanan, Sumner, Reynolds and Sebring 1 ) for the assessment of fat mass percent (FM%). We tested whether the BAI showed a stronger association with metabolic outcomes than BMI and waist circumference (WC) in a clinical population of overweight and obese women of different ages.
This is a cross-sectional analysis of a representative clinical sample in Southern Italy.
Participants: Body composition and metabolic risk were assessed in 260 young women aged 24.7 (sd=5.3) years, with a mean BMI of 31.0 (sd=5.0) kg/m2 and 328 older women aged 66.9 (sd=4.6) years, with a BMI of 34.8 (sd=4.7) kg/m2 attending a weight loss clinic. Body weight, height, waist and hip circumferences were measured. BMI and BAI were computed. Bioimpedance analysis was used to measure FM. Metabolic risk was assessed using a composite z-score integrating standardized measurements of glucose, total cholesterol, liver enzymes and triglycerides.
The association of BAI with FM% was poor in both young (r=0.56, p<0.001) and older (r=0.49, p<0.001) groups. BAI was directly associated with metabolic risk in young women (r=0.29, p<0.001) whereas it showed a weak, inverse association in the older group (r=−0.14, p=0.01). In a multiple regression model, metabolic risk was significantly associated with WC in young women (B=0.04 (se=0.02) (p=0.03)) and BAI in older women (B=−0.16 (se=0.03) p<0.001)).
In conclusion, a paradoxical association of BAI with a composite metabolic risk score in older overweight and obese women was observed. This suggests that the validity of this novel adiposity index needs to be re-assessed in older individuals in order to be utilised in clinical practice.