Abdominal height measures cardiometabolic risk better than body mass index: result of a preliminary study

Background: Obesity is associated with substantial cardiovascular morbi-mortality. The long acclaimed standard for assessing it, the BMI does not appropriately identify subjects at risk for CVD across all races. Given the varying habitus of Africans compared with people of Asian and European ancestry, and the fact that BMI does not discriminate the contribution and distribution of fat to overall weight; the need to determine what is more accurate for each group became compelling. Aims and Objective: This is an attempt to pilot the use of a new concept, the Abdominometer, in our local population in comparison the age long BMI. Study Design: Cross-sectional Descriptive. Setting: Community Forum. Materials and Methods: A small population of 31 seen during a group cardiovascular health survey with BMI and Abdominal Height data had their blood pressure and glycosylated haemoglobin measured. Ability of BMI and Abdominal height respectively to predict hypertension and diabetes was compared. Statistics: We applied sensitivity, specificity, positive and negative predictive values, accuracy as well as false positive and negative rates on data relating to AH, BMI, Blood pressure and Glycosylated haemoglobin. Results: For hypertension screening, abdominal height performed better than BMI but not impressively so for diabetes. Regarding detection of hypertension with BMI and abdominal height measurements, true positive was 4/31 and 11/31 respectively with accuracy of 61.3% and 67.9% in same sequence. With detection of diabetes using BMI and abdominal height, true positive was 2/31 and 4/31 respectively with accuracy of 29% and 41.9% in same sequence. Conclusion: For our environment, abdominal height cut-off of 25 cm is better to screen for initiation of preventive and curative action for obesity than BMI and should be more widely used for validation and acceptance.