title: Correlation of adiposity indices with cardiovascular disease risk factors in healthy adults of Singapore: a cross-sectional study.
abstract: BACKGROUND
  Obesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD). Nonetheless, the best adiposity indices to evaluate the CVD risk factors remain contentious and few studies have been performed in Asian populations. In the present study, we compared the association strength of percent body fat (PBF) to indirect anthropometric measures of general adiposity (body mass index (BMI) and body adiposity index (BAI)) and central adiposity (waist circumference (WC), and waist-to-hip ratio (WHR)) for the prediction of CVD risk factors in healthy men and women living in Singapore.
  
  
  METHODS
  A total of 125 individuals (63 men and 62 women) took part in this study. PBF was measured by using three different techniques, including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Anthropometric measurements (WC, hip circumference (HC), height, and weight), fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were determined according to standard protocols. Correlations of anthropometric measurements and PBF with CVD risk factors were compared.
  
  
  RESULTS
  Irrespective of the measuring techniques, PBF showed strong positive correlations with FSI, HOMA-IR, TC/HDL, TG/HDL, and LDL/HDL in both genders. While PBF was highly correlated with FBG, SBP, and DBP in females, no significant relationships were observed in males. Amongst the five anthropometric measures of adiposity, BAI was the best predictor for CVD risk factors in female participants (r = 0.593 for HOMA-IR, r = 0.542 for TG/HDL, r = 0.474 for SBP, and r = 0.448 for DBP). For males, the combination of WC (r = 0.629 for HOMA-IR, and r = 0.446 for TG/HDL) and WHR (r = 0.352 for SBP, and r = 0.366 for DBP) had the best correlation with CVD risk factors.
  
  
  CONCLUSIONS
  Measurement of PBF does not outperform the simple anthropometric measurements of obesity, i.e. BAI, WC, and WHR, in the prediction of CVD risk factors in healthy Asian adults. While measures of central adiposity (WC and WHR) tend to show stronger associations with CVD risk factors in males, measures of general adiposity (BAI) seems to be the best predictor in females. The gender differences in the association between adiposity indices and CVD risk factors may relate to different body fat distribution in males and females living in Singapore. These results may find further clinical utility to identify patients with CVD risk factors in a more efficient way.
authors.affiliation: Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore.
authors.forename: Xinyan
authors.initials: X
authors.lastname: Bi
authors.affiliation: Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore.
authors.forename: Siew Ling
authors.initials: SL
authors.lastname: Tey
authors.affiliation: Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore.
authors.forename: Claudia
authors.initials: C
authors.lastname: Leong
authors.affiliation: Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore.
authors.forename: Rina
authors.initials: R
authors.lastname: Quek
authors.affiliation: Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore.
authors.forename: Yi Ting
authors.initials: YT
authors.lastname: Loo
authors.affiliation: Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), 30 Medical Drive, Singapore, 117609 Singapore ; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599 Singapore.
authors.forename: Christiani Jeyakumar
authors.initials: CJ
authors.lastname: Henry
keywords: Adiposity indices; Asian; Body adiposity index; Body composition; Cardiovascular risk factors; Central adiposity; General adiposity; Waist circumference