The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes
Abstract Objective Previous studies have emphasized the independent effects of anthropometric indices—including body mass index (BMI), A Body Shape Index (ABSI), waist-to-height ratio (WHtR), body roundness index (BRI), and Conicity Index—on mortality. However, their combined impact, especially in d...
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BMC
2025-02-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01614-x |
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| author | Shuwu Wei Weimin Jiang Huijuan Zheng Jiale Zhang Jie Yang Yaoxian Wang Yang Liu Liqiao Sun Xinrong Li Junping Wei Weiwei Sun |
| author_facet | Shuwu Wei Weimin Jiang Huijuan Zheng Jiale Zhang Jie Yang Yaoxian Wang Yang Liu Liqiao Sun Xinrong Li Junping Wei Weiwei Sun |
| author_sort | Shuwu Wei |
| collection | DOAJ |
| description | Abstract Objective Previous studies have emphasized the independent effects of anthropometric indices—including body mass index (BMI), A Body Shape Index (ABSI), waist-to-height ratio (WHtR), body roundness index (BRI), and Conicity Index—on mortality. However, their combined impact, especially in diabetic populations with distinct obesity patterns, has been less frequently explored. This study investigates both the independent and combined effects of these anthropometric indices on mortality in diabetic Americans and compares their individual and combined diagnostic value. Methods A nationally representative cohort study was conducted using NHANES data (2005–2018), including 6,572 diabetic adults. Weighted Cox proportional hazards models and restricted cubic splines were applied to evaluate the independent and combined associations of anthropometric indices (BMI, ABSI, WHtR, BRI, and Conicity Index) with all-cause mortality. The weighted receiver operating characteristic (ROC) curve was used to assess the diagnostic value of individual anthropometric indices and their combinations in predicting mortality. Results Among all the anthropometric indices, ABSI exhibited the strongest independent association with all-cause mortality, outperforming other measures such as BMI, WHtR, BRI, and Conicity Index. A clear linear relationship was identified, with higher ABSI tertiles consistently linked to an increased risk of mortality. Notably, within each BMI tertile, ABSI effectively differentiated mortality risk, particularly in the highest tertile. Furthermore, ABSI demonstrated the highest predictive performance among individual metrics (weighted AUC = 0.653) and showed further improvement when combined with BMI (weighted AUC = 0.669). Conclusion BMI and ABSI collectively provide a comprehensive evaluation of mortality risk in diabetic populations, capturing the synergistic effects of general and central obesity. These findings highlight the importance of integrating BMI and ABSI into risk assessments to identify high-risk individuals and guide targeted interventions for reducing mortality. |
| format | Article |
| id | doaj-art-e4063ffd542e42d9859d35bccf87be5e |
| institution | Kabale University |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-e4063ffd542e42d9859d35bccf87be5e2025-02-09T12:48:14ZengBMCDiabetology & Metabolic Syndrome1758-59962025-02-0117111210.1186/s13098-025-01614-xThe combined impact of BMI and ABSI on all-cause mortality among American adults with diabetesShuwu Wei0Weimin Jiang1Huijuan Zheng2Jiale Zhang3Jie Yang4Yaoxian Wang5Yang Liu6Liqiao Sun7Xinrong Li8Junping Wei9Weiwei Sun10Beijing University of Chinese MedicineBeijing University of Chinese MedicineDongzhimen Hospital, Beijing University of Chinese MedicineBeijing University of Chinese MedicineBeijing University of Chinese MedicineHenan University of Chinese MedicineDepartment of Chinese Medicine, Cangzhou Central HospitalDepartment of Chinese Medicine, Cangzhou Central HospitalDepartment of Chinese Medicine, Cangzhou Central HospitalGuang’anmen Hospital, China Academy of Chinese Medical SciencesBeijing University of Chinese MedicineAbstract Objective Previous studies have emphasized the independent effects of anthropometric indices—including body mass index (BMI), A Body Shape Index (ABSI), waist-to-height ratio (WHtR), body roundness index (BRI), and Conicity Index—on mortality. However, their combined impact, especially in diabetic populations with distinct obesity patterns, has been less frequently explored. This study investigates both the independent and combined effects of these anthropometric indices on mortality in diabetic Americans and compares their individual and combined diagnostic value. Methods A nationally representative cohort study was conducted using NHANES data (2005–2018), including 6,572 diabetic adults. Weighted Cox proportional hazards models and restricted cubic splines were applied to evaluate the independent and combined associations of anthropometric indices (BMI, ABSI, WHtR, BRI, and Conicity Index) with all-cause mortality. The weighted receiver operating characteristic (ROC) curve was used to assess the diagnostic value of individual anthropometric indices and their combinations in predicting mortality. Results Among all the anthropometric indices, ABSI exhibited the strongest independent association with all-cause mortality, outperforming other measures such as BMI, WHtR, BRI, and Conicity Index. A clear linear relationship was identified, with higher ABSI tertiles consistently linked to an increased risk of mortality. Notably, within each BMI tertile, ABSI effectively differentiated mortality risk, particularly in the highest tertile. Furthermore, ABSI demonstrated the highest predictive performance among individual metrics (weighted AUC = 0.653) and showed further improvement when combined with BMI (weighted AUC = 0.669). Conclusion BMI and ABSI collectively provide a comprehensive evaluation of mortality risk in diabetic populations, capturing the synergistic effects of general and central obesity. These findings highlight the importance of integrating BMI and ABSI into risk assessments to identify high-risk individuals and guide targeted interventions for reducing mortality.https://doi.org/10.1186/s13098-025-01614-xDiabetesAll-cause mortalityCentral obesityA body shape indexBody mass index |
| spellingShingle | Shuwu Wei Weimin Jiang Huijuan Zheng Jiale Zhang Jie Yang Yaoxian Wang Yang Liu Liqiao Sun Xinrong Li Junping Wei Weiwei Sun The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes Diabetology & Metabolic Syndrome Diabetes All-cause mortality Central obesity A body shape index Body mass index |
| title | The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes |
| title_full | The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes |
| title_fullStr | The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes |
| title_full_unstemmed | The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes |
| title_short | The combined impact of BMI and ABSI on all-cause mortality among American adults with diabetes |
| title_sort | combined impact of bmi and absi on all cause mortality among american adults with diabetes |
| topic | Diabetes All-cause mortality Central obesity A body shape index Body mass index |
| url | https://doi.org/10.1186/s13098-025-01614-x |
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