Abstract
BACKGROUND: To our knowledge, 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 a 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 3-point major adverse cardiac events (MACEs), 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 5 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 {hazard ratio (HR) per SD 1.15, [95% confidence interval (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 (5% 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 cut-off 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 >13 y of follow-up than BMI, WC, and ABSI. The identified cutoffs may help improve risk stratification and support early preventive interventions to reduce cardiovascular disease risk.