Anthropometric Indices for Predicting Incident Cardiovascular Disease : A 13-Year Follow-Up Study in a Japanese population.

Background: No previous study has compared the predictive capacity of various anthropometric indices of cardiovascular disease (CVD) risk in East Asians.

Objective: This study aimed to compare which anthropometric indices have greater impact on CVD in the Japanese population.

Methods: Data from a health checkup program conducted by the Panasonic Corporation between 2008 and 2021, including 160,656 participants, were analyzed. The primary outcome was the incidence of three-point major adverse cardiac events (MACE), including cardiovascular death, nonfatal coronary artery disease, and nonfatal stroke. Cox proportional hazards models and time-dependent receiver operating characteristic (ROC) analyses were used to evaluate the associations between five anthropometric indices (body mass index [BMI], waist circumference [WC], A Body Shape Index [ABSI], Body Roundness Index [BRI], and waist-to-height ratio [WHtR]) and incident MACE, stratified by gender.

Results: Multivariate analysis showed that all anthropometric indices were associated with incident MACE in males: BMI (HR per SD 1.15, [95% CI 1.11, 1.18]), WC (1.15, [1.12, 1.19]), ABSI (1.06, [1.02, 1.09]), BRI (1.16, [1.13, 1.20]), and WHtR (1.17, [1.13, 1.21]). In females, no significant associations were found between any anthropometric indices and the incident MACE. Among males, the areas under the curve values for BRI and WHtR (both 0.608 [95% CI: 0.598, 0.618]) were higher than those for BMI (0.586 [95% CI: 0.576, 0.596]), WC (0.598 [95% CI: 0.588, 0.608]), and ABSI (0.563 [95% CI: 0.552, 0.573]), with the values for BRI and WHtR being identical. The optimal cutoff values for predicting CVD were 3.250 for BRI and 0.494 for WHtR.

Conclusions: BRI and WHtR were more significant predictors of incident CVD in Japanese males over 13 years of follow-up than BMI, WC, and ABSI. The identified cutoffs may help improve risk stratification and support early preventive interventions to reduce cardiovascular risk.