Association of Traditional and Emerging Anthropometric Indices With Subclinical Carotid Atherosclerosis in Young Healthy Adults: Insights From the Tehran Lipid and Glucose Study
Behnaz Abiri, Amirhossein Ramezani Ahmadi, Farhad Hosseinpanah, Pooneh Dehghan, Azra Ramezankhani, Maryam Mataji‐Amirroud, Nika Farsinajad, Fereidoun Azizi, Majid ValizadehABSTRACT
Background
Obesity is a major risk factor for cardiovascular disease, but traditional measures like BMI and waist circumference have limitations. New indices, BRI and ABSI, may better reflect fat distribution and cardiovascular risk. This study examined their association with carotid intima‐media thickness (cIMT) in young healthy adults.
Methods
In this cross‐sectional study within the Tehran Lipid and Glucose Study (TLGS) framework, 572 adults aged 20–40 years underwent anthropometric assessments, biochemical tests and carotid ultrasound for cIMT measurement. Anthropometric indices including BMI, WC, waist‐to‐height ratio (WHtR), ABSI and BRI were calculated. Associations between these indices and cIMT were analysed using correlation and multivariable linear regression models adjusting for demographic, metabolic and lifestyle factors. Receiver operating characteristic (ROC) curve analyses assessed the predictive ability of the indices for elevated cIMT.
Result
BRI and WHtR were nearly collinear ( r = 0.997) and showed modest positive correlations with cIMT in unadjusted analyses ( r = 0.103 for both), but these associations weakened after adjustment for cardiometabolic risk factors. WC was the only independent predictor of cIMT in partially adjusted models, though this significance disappeared in fully adjusted analyses. ABSI exhibited a significant but mechanistically unexpected inverse association with cIMT. ROC analyses indicated limited discriminative power for all anthropometric measures in predicting high cIMT, with BRI and WHtR having the highest but still modest area under the curve (AUC).
Conclusion
In young healthy adults, BRI and WHtR showed modest associations with subclinical carotid atherosclerosis, which weakened after adjustment. Waist circumference was an inconsistent predictor, and ABSI demonstrated an inverse relationship with cIMT. Further longitudinal studies are needed to confirm their clinical utility.