Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study

Abstract This study aimed to evaluate the predictive capacity of the Body Roundness Index (BRI), Abdominal Body Shape Index (ABSI), Waist-to-Weight Index (WWI), and Waist-to-Height Ratio (WHtR) for sarcopenic obesity (SO) incidence among older adults in China using data from the Chinese Longitudinal...

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Main Authors: Chen Zhang, Landan Xiao, Hao Lu, Huisheng Deng
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06310-z
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author Chen Zhang
Landan Xiao
Hao Lu
Huisheng Deng
author_facet Chen Zhang
Landan Xiao
Hao Lu
Huisheng Deng
author_sort Chen Zhang
collection DOAJ
description Abstract This study aimed to evaluate the predictive capacity of the Body Roundness Index (BRI), Abdominal Body Shape Index (ABSI), Waist-to-Weight Index (WWI), and Waist-to-Height Ratio (WHtR) for sarcopenic obesity (SO) incidence among older adults in China using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The cohort included 3,919 participants aged 65 and older, with a mean follow-up of 2.79 years. Sarcopenic obesity was defined by low muscle mass and high body fat. Multivariate Cox proportional hazards regression models and Generalized Additive Models (GAMs) based on the Poisson distribution were used to assess the associations and predictive performance of these indices. After adjustment, BRI (HR: 1.037, 95% CI: 1.014, 1.060), ABSI (HR: 13.247, 95% CI: 1.677, 104.660), WWI (HR: 1.023, 95% CI: 1.006, 1.040), and WHtR (HR: 1.007, 95% CI: 1.003, 1.010) were significant predictors of SO incidence. Threshold effect analyses revealed non-linear relationships for BRI and WHtR. The predictive model based on GAMs demonstrated strong discrimination (C-index: 0.879 for the modeling set and 0.876 for the validation set) and good clinical utility. These findings highlight the importance of early intervention for individuals with abdominal obesity to prevent future sarcopenic obesity, thereby reducing disease and social burdens and improving the quality of life for the elderly.
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spelling doaj-art-01cd20545ccb46588f12944f1cb6f8f82025-08-24T11:49:23ZengBMCBMC Geriatrics1471-23182025-08-0125111410.1186/s12877-025-06310-zPredictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort studyChen Zhang0Landan Xiao1Hao Lu2Huisheng Deng3Department of General Practice, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of General Practice, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of General Practice, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of General Practice, The First Affiliated Hospital of Chongqing Medical UniversityAbstract This study aimed to evaluate the predictive capacity of the Body Roundness Index (BRI), Abdominal Body Shape Index (ABSI), Waist-to-Weight Index (WWI), and Waist-to-Height Ratio (WHtR) for sarcopenic obesity (SO) incidence among older adults in China using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The cohort included 3,919 participants aged 65 and older, with a mean follow-up of 2.79 years. Sarcopenic obesity was defined by low muscle mass and high body fat. Multivariate Cox proportional hazards regression models and Generalized Additive Models (GAMs) based on the Poisson distribution were used to assess the associations and predictive performance of these indices. After adjustment, BRI (HR: 1.037, 95% CI: 1.014, 1.060), ABSI (HR: 13.247, 95% CI: 1.677, 104.660), WWI (HR: 1.023, 95% CI: 1.006, 1.040), and WHtR (HR: 1.007, 95% CI: 1.003, 1.010) were significant predictors of SO incidence. Threshold effect analyses revealed non-linear relationships for BRI and WHtR. The predictive model based on GAMs demonstrated strong discrimination (C-index: 0.879 for the modeling set and 0.876 for the validation set) and good clinical utility. These findings highlight the importance of early intervention for individuals with abdominal obesity to prevent future sarcopenic obesity, thereby reducing disease and social burdens and improving the quality of life for the elderly.https://doi.org/10.1186/s12877-025-06310-zSarcopenic obesityWHtRLassoGAMsRandom forest
spellingShingle Chen Zhang
Landan Xiao
Hao Lu
Huisheng Deng
Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study
BMC Geriatrics
Sarcopenic obesity
WHtR
Lasso
GAMs
Random forest
title Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study
title_full Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study
title_fullStr Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study
title_full_unstemmed Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study
title_short Predictive efficacy of waist-related indices for sarcopenic obesity incidence in Chinese older adults: a nationwide cohort study
title_sort predictive efficacy of waist related indices for sarcopenic obesity incidence in chinese older adults a nationwide cohort study
topic Sarcopenic obesity
WHtR
Lasso
GAMs
Random forest
url https://doi.org/10.1186/s12877-025-06310-z
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AT landanxiao predictiveefficacyofwaistrelatedindicesforsarcopenicobesityincidenceinchineseolderadultsanationwidecohortstudy
AT haolu predictiveefficacyofwaistrelatedindicesforsarcopenicobesityincidenceinchineseolderadultsanationwidecohortstudy
AT huishengdeng predictiveefficacyofwaistrelatedindicesforsarcopenicobesityincidenceinchineseolderadultsanationwidecohortstudy