ArticleJournal of cachexia, sarcopenia and muscle2025
The Combination of Fat Distribution and BMI Redefines Obesity: Result From NHANES.
Article in Journal of cachexia, sarcopenia and muscle, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Visceral fat score predicts diabetic kidney disease: analysis of 20 years of U.S. NHANES data.Renal failure · 2026Article
- Spatiotemporal dynamics of the host-tumor metabolic interface: Implications for precision nutritional oncology.Genes & diseases · 2026Review
- Does the obesity paradox truly exist? A study on the relationship between different degrees of obesity and stroke incidence and mortality based on the UK Biobank.BMC public health · 2026Article
- Accurate and spatially stable quantification of hepatic steatosis using ultrasound-derived fat fraction in metabolic dysfunction-associated steatotic liver disease (MASLD): a prospective magnetic resonance imaging-proton density fat fraction (MRI-PDFF) study.Quantitative imaging in medicine and surgery · 2026Article
- Obesity trajectories based on the European association for the study diagnostic framework and their associations with cardiovascular disease: evidence from two longitudinal cohorts.BMC public health · 2026Article
- Refining Osteoarthritis Risk Prediction: Average Sagittal Abdominal Diameter Complements and Enhances Body Mass Index With Sex-Specific Insights From National Health and Nutrition Examination Survey.Health care science · 2026Article
- Sarcopenia and MASLD: novel insights and the future.Nature reviews. Endocrinology · 2026Review
- Visceral fat area and visceral-to-subcutaneous fat ratio are more strongly associated with residual cholesterol than conventional anthropometric indices in adults with type 2 diabetes.Frontiers in endocrinology · 2026Article
- The Systemic Immune-Inflammation Index as a Predictor of Clinical Outcomes in Chronic Coronary Syndrome: Influence of Diabetes Mellitus.Journal of inflammation research · 2026Article
- Association and prognostic value of adiposity distribution indices for all-cause mortality in cardiovascular-kidney-metabolic syndrome stages 0-3: a nationwide study.Therapeutic advances in endocrinology and metabolism · 2026Article
- Clinical Obesity Through the Lens of Context-Aware Large Language Models.Obesity surgery · 2025Article
- Anthropometric indices and mortality in postmenopausal women: NHANES 1999-2018 evidence.BMC women's health · 2025Article
- The Combination of Fat Distribution and BMI Redefines Obesity: Result From NHANES.Journal of cachexia, sarcopenia and muscle · 2025Article
- Relative fat mass is associated with vitamin D deficiency in individuals with diabetes: evidence from NHANES and a Chinese cohort.Frontiers in endocrinology · 2025Article
- The evolving concepts in visceral obesity: What anesthesiologists need to know.Saudi journal of anaesthesiaReview
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundBody mass index (BMI) has well-recognized limitations, particularly in the context of the 'obesity paradox', where higher BMI does not consistently evaluate adverse outcomes. These limitations underscore the need for alternative approaches. This study aimed to redefine obesity using anthropometric indicators and to assess their prognostic value for mortality.
methodsThe original cohort included participants from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006. Additional dual-energy X-ray absorptiometry (DXA) data on fat distribution were sourced from NHANES 1999-2006 and 2011-2018. Ten fat distribution indicators were adopted to assess the fat distribution in the target population, including five centripetal obesity indicators, three global obesity indicators and two limb obesity indicators. All-cause, cardiovascular-specific and cancer-specific mortality outcomes were examined using weighted Cox proportional hazards models. Logistic regression was employed to evaluate associations between fat distribution indicators and the prevalence of specific diseases.
resultsThis study included 14 936 participants (weighted 152 823 236 participants, mean age: 45.56 ± 17.60 years) and two DXA-assessed cohorts. Fat distribution indicators were correlated with various DXA-defined fat components. All 10 indicators demonstrated significant associations with mortality. Notably, the relationship between centripetal obesity indicators and all-cause mortality was approximately linear in both sexes. Centripetal obesity was also strongly associated with cardiovascular and cancer-specific mortality (p < 0.001). Although fat distribution indicators were significantly linked to the prevalence of cardiovascular disease (CVD), they showed no clear association with cancer incidence. Individuals with obesity but without centripetal fat accumulation exhibited a similar or slightly higher mortality risk compared with those with normal BMI and no centripetal obesity.
conclusionCentripetal obesity indicators emerged as the strongest independent evaluators of mortality, regardless of BMI classification. These findings highlight the clinical value of incorporating fat distribution metrics alongside BMI to more accurately assess obesity-related mortality risk.
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