Fidelity of BMI, Waist, and Waist-to-Height Ratio as Adiposity Measures in Normoglycemic Black vs White American Adults.

IF 3 Q2 ENDOCRINOLOGY & METABOLISM Journal of the Endocrine Society Pub Date : 2024-11-13 eCollection Date: 2024-11-26 DOI:10.1210/jendso/bvae202

Zhao Liu, Peace Asuzu, Avnisha Patel, Jim Wan, Samuel Dagogo-Jack

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Abstract

Objective: To assess ethnic disparities in the association between indirect and direct measures of adiposity in African American (AA) and European American (EA) adults.

Methods: We analyzed the indirect [weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR)] and direct [total fat, trunk fat, fat-free mass (FFM)] adiposity measures in healthy AA and EA adults. Assessments included anthropometry, oral glucose tolerance test, body composition by dual-energy X-ray absorptiometry (DXA), and calculation of direct-to-indirect adiposity ratios (total fat/BMI, trunk fat/WC, trunk fat/WHtR, and FFM/weight).

Results: A total of 314 subjects (167 AA, 147 EA) underwent DXA. All participants (mean age 44.2 ± 10.6 years) had normal fasting and 2-hour glucose values. The BMI (AA vs EA) was 31.2 ± 7.42 kg/m² vs28.8 ± 6.78 kg/m² (P = .0014); WC 95.3 ± 16.0 cm vs 92.9 ± 15.0 cm (P = .15). Significant correlations (P < .0001) were observed between BMI and total fat (r = 0.68), WC, and trunk fat (r = 0.61) and WHtR vs trunk fat (r = 0.77) for the combined cohort, with heterogeneity in the strength of association by sex and ethnicity. Fat-free mass was higher in AA vs EA participants (P = .03). Total fat/BMI was lower in AA vs EA participants (P = .0047); trunk fat/WC (P = .004) and trunk fat/WHtR (P = .0026) were lower in AA men vs EA men.

Conclusion: The BMI overestimated body fat in AA participants vs EA participants, and WC overestimated trunk fat in AA men vs EA men. These data indicate ethnic disparities in the fidelity of indirect measures of adiposity and argue for ethnic-specific BMI thresholds for determination of overweight/obesity.

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BMI、腰围和腰高比作为正常血糖水平的美国黑人和白人成年人肥胖测量指标的保真度

目的：评估非裔美国人（AA）和欧裔美国人（EA）成年人间接和直接肥胖测量之间的种族差异。方法：分析AA和EA健康成人的间接[体重、身体质量指数（BMI）、腰围（WC）、腰高比（WHtR）]和直接[总脂肪、躯干脂肪、无脂质量（FFM）]肥胖指标。评估包括人体测量、口服葡萄糖耐量试验、双能x线吸收仪（DXA）的身体组成，以及直接与间接脂肪比（总脂肪/BMI、躯干脂肪/WC、躯干脂肪/WHtR和FFM/体重）的计算。结果：314例患者（AA 167例，EA 147例）行DXA。所有参与者（平均年龄44.2±10.6岁）空腹和2小时血糖值正常。BMI （AA vs EA）分别为31.2±7.42 kg/m2 vs28.8±6.78 kg/m2 (P = 0.0014)；wc95.3±16.0 cm vs 92.9±15.0 cm （P = 0.15）。在合并队列中，BMI与总脂肪（r = 0.68）、腰围和躯干脂肪（r = 0.61）以及腰臀比与躯干脂肪（r = 0.77）之间存在显著相关性（P < 0.0001），性别和种族之间的关联强度存在异质性。AA组的无脂质量高于EA组（P = .03）。AA组总脂肪/BMI低于EA组（P = 0.0047）；AA男性躯干脂肪/WC （P = 0.004）和躯干脂肪/WHtR （P = 0.0026）低于EA男性。结论：AA组BMI高估了EA组体脂，WC高估了AA组躯干脂。这些数据表明，在肥胖间接测量的保真度方面存在种族差异，并为确定超重/肥胖的种族特异性BMI阈值提供了依据。

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