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Original article Comparative analysis of body mass index and obesity-related anthropometric indices for mortality prediction: a study of the Namwon and Dong-gu cohorts
Ye-Rim Kim1orcid , Min-Ho Shin2orcid , Young-Hoon Lee3orcid , Seong-Woo Choi4orcid , Hae-Sung Nam5orcid , Jeong-Ho Yang2orcid , Sun-Seog Kweon1,2orcid
Epidemiol Health 2024;e2024066
DOI: https://doi.org/10.4178/epih.e2024066 [Accepted]
Published online: July 17, 2024
1Interdisplinary Program of Public Health, Chonnam National University, Hwasun-gun, Korea
2Chonnam National University Medical School, Hwasun-gun, Korea
3Wonkwang University College of Medicine, Iksan, Korea
4Chosun University Medical School, Gwangju, Korea
5Chungnam National University College of Medicine, Daejeon, Korea
6Chonnam National Univerity Hwasun Hospital, Hwasun-gun, Korea
Corresponding author:  Sun-Seog Kweon,
Email: ujingogo@paran.com
Received: 4 March 2024   • Revised: 29 June 2024   • Accepted: 5 July 2024
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Abstract

OBJECTIVES
This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI).
METHODS
We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell c-index.
RESULTS
Adding anthropometric indices to the basic mortality model (c-index 0.7723; 95% CI, 0.7647-0.7799) significantly increased the predictive power of BMI (c-index 0.7735; 95% CI, 0.7659-0.7811), a body shape index (ABSI, c-index 0.7735; 95% CI, 0.7659-0.7810), weight-adjusted waist index (WWI, c-index 0.7731; 95% CI, 0.7656-0.7807), and waist to hip index (WHI, c-index 0.7733; 95% CI, 0.7657-0.7809). The differences between the BMI model and the other 3 models were not statistically significant.
CONCLUSIONS
In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.

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