Comparative performance of anthropometric indices in predicting cardiometabolic risk severity in black adults

D Ibirogba; Matteo Crotti; Sarah Charman; F Bukachi; Peter Mwangi; M Duncan; D Jakovljevic; Nduka Okwose

doi:10.1093/eurjpc/zwag249.169

Abstract

Background Waist-to-Height ratio (WHtR), Body Roundness Index (BRI), and A Body Shape Index (ABSI) are emerging anthropometric indicators of obesity that provide alternative assessments of body shape and fat distribution. Purpose This study evaluated the performance of these indices relative to the traditional Body Mass Index (BMI) in predicting cardiometabolic risk severity (cMetS) among Black adults. Methods 75 Black adults of sub-Saharan African descent (51% female; mean age: 40 ± 10 years) residing in the West Midlands, UK, were assessed for WHtR, BRI, ABSI, BMI, and cMetS. The cMetS score was calculated using standardised z-scores for waist circumference, systolic blood pressure, random glucose, non-HDL cholesterol, and HDL cholesterol. Pearson correlation analyses were conducted to explore bivariate associations, while multiple linear regression was used to evaluate the independent contributions of the anthropometric measures to cMetS. Results Average cMetS score was −0.04 ± 0.5, with males showing a higher mean score (0.1 ± 0.6) compared to females (−0.2 ± 0.5). The mean WHtR, BRI, ABSI and BMI were 0.55 ± 0.08, 4.4 ± 1.6, 0.74 ± 0.06, and 29.4 ± 5.6 kg/m², respectively. Significant positive correlations were observed between cMetS and WHtR (r = 0.54), BRI (r = 0.53), ABSI (r = 0.36), and BMI (r = 0.40) (p < 0.001 for all). After adjusting for age, linear regression analyses showed that WHtR (adjusted R2 = 0.27, B = 3.59, β = 0.523, p < 0.001), BRI (adjusted R2 = 0.26, B = 0.17, β = 0.513, p < 0.001), ABSI (adjusted R2 = 0.11, B = 3.16, β = 0.336, p = 0.006) and BMI (adjusted R2 = 0.17, B = 0.04, β = 0.394, p < 0.001), were all independent predictors of cMetS. Conclusion Anthropometric measures evaluated in this study showed significant positive associations with cMetS, but Waist-to-Height ratio and Body Roundness Index accounted for greater variance in risk, indicating superior discriminatory performance and thus, stronger predictors of cardiometabolic risk severity than the conventional Body Mass Index among Black adults. Notwithstanding, WHtR offers a superior balance of accuracy, simplicity, and practicality, making it a more feasible tool for widespread clinical and community-based use.

Original language	English
Number of pages	1
DOIs	https://doi.org/10.1093/eurjpc/zwag249.169
Publication status	E-pub ahead of print - 11 Jun 2026
Event	ESC Preventive Cardiology 2026 - Ljubljana, Slovenia Duration: 23 Apr 2026 → 25 Apr 2026

Conference

Conference	ESC Preventive Cardiology 2026
Country/Territory	Slovenia
City	Ljubljana
Period	23/04/26 → 25/04/26

Bibliographical note

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Cite this

@conference{a627c1e3bb484892a2b9f87ba5d06019,

title = "Comparative performance of anthropometric indices in predicting cardiometabolic risk severity in black adults",

abstract = "Background Waist-to-Height ratio (WHtR), Body Roundness Index (BRI), and A Body Shape Index (ABSI) are emerging anthropometric indicators of obesity that provide alternative assessments of body shape and fat distribution. Purpose This study evaluated the performance of these indices relative to the traditional Body Mass Index (BMI) in predicting cardiometabolic risk severity (cMetS) among Black adults. Methods 75 Black adults of sub-Saharan African descent (51\% female; mean age: 40 ± 10 years) residing in the West Midlands, UK, were assessed for WHtR, BRI, ABSI, BMI, and cMetS. The cMetS score was calculated using standardised z-scores for waist circumference, systolic blood pressure, random glucose, non-HDL cholesterol, and HDL cholesterol. Pearson correlation analyses were conducted to explore bivariate associations, while multiple linear regression was used to evaluate the independent contributions of the anthropometric measures to cMetS. Results Average cMetS score was −0.04 ± 0.5, with males showing a higher mean score (0.1 ± 0.6) compared to females (−0.2 ± 0.5). The mean WHtR, BRI, ABSI and BMI were 0.55 ± 0.08, 4.4 ± 1.6, 0.74 ± 0.06, and 29.4 ± 5.6 kg/m², respectively. Significant positive correlations were observed between cMetS and WHtR (r = 0.54), BRI (r = 0.53), ABSI (r = 0.36), and BMI (r = 0.40) (p < 0.001 for all). After adjusting for age, linear regression analyses showed that WHtR (adjusted R2 = 0.27, B = 3.59, β = 0.523, p < 0.001), BRI (adjusted R2 = 0.26, B = 0.17, β = 0.513, p < 0.001), ABSI (adjusted R2 = 0.11, B = 3.16, β = 0.336, p = 0.006) and BMI (adjusted R2 = 0.17, B = 0.04, β = 0.394, p < 0.001), were all independent predictors of cMetS. Conclusion Anthropometric measures evaluated in this study showed significant positive associations with cMetS, but Waist-to-Height ratio and Body Roundness Index accounted for greater variance in risk, indicating superior discriminatory performance and thus, stronger predictors of cardiometabolic risk severity than the conventional Body Mass Index among Black adults. Notwithstanding, WHtR offers a superior balance of accuracy, simplicity, and practicality, making it a more feasible tool for widespread clinical and community-based use.",

author = "D Ibirogba and Matteo Crotti and Sarah Charman and F Bukachi and Peter Mwangi and M Duncan and D Jakovljevic and Nduka Okwose",

note = "This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].; ESC Preventive Cardiology 2026 ; Conference date: 23-04-2026 Through 25-04-2026",

year = "2026",

month = jun,

day = "11",

doi = "10.1093/eurjpc/zwag249.169",

language = "English",

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TY - CONF

T1 - Comparative performance of anthropometric indices in predicting cardiometabolic risk severity in black adults

AU - Ibirogba, D

AU - Crotti, Matteo

AU - Charman, Sarah

AU - Bukachi, F

AU - Mwangi, Peter

AU - Duncan, M

AU - Jakovljevic, D

AU - Okwose, Nduka

N1 - This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2026/6/11

Y1 - 2026/6/11

N2 - Background Waist-to-Height ratio (WHtR), Body Roundness Index (BRI), and A Body Shape Index (ABSI) are emerging anthropometric indicators of obesity that provide alternative assessments of body shape and fat distribution. Purpose This study evaluated the performance of these indices relative to the traditional Body Mass Index (BMI) in predicting cardiometabolic risk severity (cMetS) among Black adults. Methods 75 Black adults of sub-Saharan African descent (51% female; mean age: 40 ± 10 years) residing in the West Midlands, UK, were assessed for WHtR, BRI, ABSI, BMI, and cMetS. The cMetS score was calculated using standardised z-scores for waist circumference, systolic blood pressure, random glucose, non-HDL cholesterol, and HDL cholesterol. Pearson correlation analyses were conducted to explore bivariate associations, while multiple linear regression was used to evaluate the independent contributions of the anthropometric measures to cMetS. Results Average cMetS score was −0.04 ± 0.5, with males showing a higher mean score (0.1 ± 0.6) compared to females (−0.2 ± 0.5). The mean WHtR, BRI, ABSI and BMI were 0.55 ± 0.08, 4.4 ± 1.6, 0.74 ± 0.06, and 29.4 ± 5.6 kg/m², respectively. Significant positive correlations were observed between cMetS and WHtR (r = 0.54), BRI (r = 0.53), ABSI (r = 0.36), and BMI (r = 0.40) (p < 0.001 for all). After adjusting for age, linear regression analyses showed that WHtR (adjusted R2 = 0.27, B = 3.59, β = 0.523, p < 0.001), BRI (adjusted R2 = 0.26, B = 0.17, β = 0.513, p < 0.001), ABSI (adjusted R2 = 0.11, B = 3.16, β = 0.336, p = 0.006) and BMI (adjusted R2 = 0.17, B = 0.04, β = 0.394, p < 0.001), were all independent predictors of cMetS. Conclusion Anthropometric measures evaluated in this study showed significant positive associations with cMetS, but Waist-to-Height ratio and Body Roundness Index accounted for greater variance in risk, indicating superior discriminatory performance and thus, stronger predictors of cardiometabolic risk severity than the conventional Body Mass Index among Black adults. Notwithstanding, WHtR offers a superior balance of accuracy, simplicity, and practicality, making it a more feasible tool for widespread clinical and community-based use.

AB - Background Waist-to-Height ratio (WHtR), Body Roundness Index (BRI), and A Body Shape Index (ABSI) are emerging anthropometric indicators of obesity that provide alternative assessments of body shape and fat distribution. Purpose This study evaluated the performance of these indices relative to the traditional Body Mass Index (BMI) in predicting cardiometabolic risk severity (cMetS) among Black adults. Methods 75 Black adults of sub-Saharan African descent (51% female; mean age: 40 ± 10 years) residing in the West Midlands, UK, were assessed for WHtR, BRI, ABSI, BMI, and cMetS. The cMetS score was calculated using standardised z-scores for waist circumference, systolic blood pressure, random glucose, non-HDL cholesterol, and HDL cholesterol. Pearson correlation analyses were conducted to explore bivariate associations, while multiple linear regression was used to evaluate the independent contributions of the anthropometric measures to cMetS. Results Average cMetS score was −0.04 ± 0.5, with males showing a higher mean score (0.1 ± 0.6) compared to females (−0.2 ± 0.5). The mean WHtR, BRI, ABSI and BMI were 0.55 ± 0.08, 4.4 ± 1.6, 0.74 ± 0.06, and 29.4 ± 5.6 kg/m², respectively. Significant positive correlations were observed between cMetS and WHtR (r = 0.54), BRI (r = 0.53), ABSI (r = 0.36), and BMI (r = 0.40) (p < 0.001 for all). After adjusting for age, linear regression analyses showed that WHtR (adjusted R2 = 0.27, B = 3.59, β = 0.523, p < 0.001), BRI (adjusted R2 = 0.26, B = 0.17, β = 0.513, p < 0.001), ABSI (adjusted R2 = 0.11, B = 3.16, β = 0.336, p = 0.006) and BMI (adjusted R2 = 0.17, B = 0.04, β = 0.394, p < 0.001), were all independent predictors of cMetS. Conclusion Anthropometric measures evaluated in this study showed significant positive associations with cMetS, but Waist-to-Height ratio and Body Roundness Index accounted for greater variance in risk, indicating superior discriminatory performance and thus, stronger predictors of cardiometabolic risk severity than the conventional Body Mass Index among Black adults. Notwithstanding, WHtR offers a superior balance of accuracy, simplicity, and practicality, making it a more feasible tool for widespread clinical and community-based use.

U2 - 10.1093/eurjpc/zwag249.169

DO - 10.1093/eurjpc/zwag249.169

M3 - Abstract

T2 - ESC Preventive Cardiology 2026

Y2 - 23 April 2026 through 25 April 2026

ER -