05 May Fat/Bone Ratio Correlates Better with Obesity Risks than BMI
MedicalResearch.com Interview with:
Albert Roh MD
Maricopa Integrated Health System
MedicalResearch.com: What is the background for this study?
Dr. Roh: Obesity is well documented to be associated with many medical conditions. Currently, obesity is defined as body mass index (BMI) over 30 kg/m^2. Although simple to calculate and relatively accurate, BMI has its limitations. BMI does not factor in the subject’s body type or fat distribution pattern. For example, a muscular subject and a fatty subject may both have BMI of 30 and be considered obese, although the muscular subject would not be predisposed to the comorbidities associated with obesity. Similarly, two subjects may have the same BMI but have different fat distribution patterns: “apple” with fat distributed primarily on the chest/abdomen and “pear” with fat distributed on the hips. The “apple” fat distribution correlates better with the comorbidities associated with obesity.
MedicalResearch.com: What are the main findings?
Dr. Roh: Our study evaluates a novel measurement of obesity: fat/bone ratio. Fat/bone ratio is calculated by dividing the soft-tissue thickness overlying the acromioclavicular joints in the shoulders by the clavicle diameter. This location is easy to reproduce on chest X-ray and has minimal variability in muscularity; any thickening of the soft tissue at this location is from “apple” distribution of fat, rather than muscle.
Of the comorbidities associated with obesity that our study analyzed, hypertension, diabetes, hyperlipidemia, obstructive sleep apnea, and osteoarthritis are associated with both BMI and fat/bone ratio (p < 0.05). However, only fat/bone ratio is associated with atherosclerosis (p = 0.02), coronary artery disease (p = 0.001), myocardial infarction (p = 0.002), and peripheral vascular disease (p = 0.01); BMI is not associated with these comorbidities (p = 0.90, 0.42, 0.25, and 0.50, respectively). Neither BMI (p = 0.83) nor fat/bone ratio (p = 0.08) is associated with cerebrovascular accident.
MedicalResearch.com: What should readers take away from your report?
Dr. Roh: Fat/bone ratio is an improved measurement of obesity; it is more closely associated with most of the established comorbidities when compared to BMI. Fat/bone ratio factors in body type and fat distribution pattern, while BMI does not.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Roh: Our study is a retrospective review of 2703 subjects. Although our study is well powered, prospective research is warranted to confirm and establish category threshold values, similar to those of BMI. Other future considerations include the application of the fat/bone ratio concept to other anatomic locations, such as the abdomen and pelvis.
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Citation: Abstract presented at the
American Roentgen Ray Society (ARRS) 2016 Annual Meeting:
Fat-to-Bone Ratio: A New Measurement of Obesity
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