The association of measures of adiposity: Body mass index, visceral adiposity index and lipid accumulation product with markers of Metabolic Syndrome in young adults

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Nouralsalhin Abdalhamid Alaagib
Rabab Mohammed Elbashir
Huda Mahgoub Ali


Background and objectives: Obesity and Metabolic syndrome (MetS) among young adults
is increasing worldwide. This study investigated the relation between body mass index (BMI), waist
circumference (WC), Visceral Adiposity Index (VAI) and Lipid Accumulation Product (LAP), as markers
of obesity in young adults, with markers of MetS: blood pressure (BP), fasting blood glucose (FBG), plasma
triglycerides (TG), high density lipoproteins (HDL), low density lipoproteins (LDL) and total cholesterol.
Methods One hundred and fifty young adults (66 male and 84 females) aged between 18-25
years volunteered to participate in the study. BP and anthropometric measurements including height, weight
and WC were done. BMI was calculated as weight/hight
). A fasting venous blood sample was taken
to measure FBG, plasma TG, HDL, LDL and cholesterol. Lipid Accumulation Product (LAP) and Visceral
Adiposity Index (VAI) were calculated.
Results Overweight and obese young adults had a significantly higher BP, higher LDL and lower HDL
compared to normal weight subjects ((P=0.001), (P=0.005) and (P=0.0001), respectively. BMI showed
highly significant positive correlation with BP (P=0.001) and LDL (P=0.005) and a highly significant
negative correlation with HDL (P=0.001). WC associated positively with BP (P=0.0001) and negatively
with HDL (P=0.0001).VAI and LAP showed a significant correlation with LDL (P=0.04) and a highly
significant negative correlation with HDL (P=0.0001).
Conclusion Both BMI and WC are simple and cheap parameters which showed significant association
with most of the markers of MetS in young adults. They can be used as predictors of MetS in young adults
especially in communities with limited financial resources.

Article Details

Original Articles



1. Björntorp P. Visceral obesity: a “civilization syndrome”. Obesity Research 1993;1:206-22.

2. Alberti KGM, Zimmet P, Shaw J. The metabolic syndrome - a new worldwide definition. The Lancet 2005;366:1059-62.

3. Grundy SM, Cleeman JI, Daniels SR, et al.
Diagnosis and management of the metabolic syndrome: an American Heart Association/ National Heart, Lung, and Blood Institute scientificstatement.Circulation 2005;112:2735-

4. National CEPN. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation

5. O’neill S, O’driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obesity Reviews

6. Alberti K, Eckel RH, Grundy SM, et al.
Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention, National Heart, Lung and Blood Institute; American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the study of obesity. Circulation 2009;120:1640-5.

7. Grundy SM. Metabolic syndrome update. Trends
in Cardiovascular Medicine 2016;26:364-73.

8. Yasir H, Tahir O, Leena B, Imam S. Metabolic syndrome and its association with obesity and lifestyle factors in Sudanese population. DiabetesandMetabolicSyndrome 2016;10:128-

9. Shuster A, Patlas M, Pinthus J, Mourtzakis M.
The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. The British Journal of Radiology

10. MChakrabortyB,ChakrabortyR.Sensitivityand specificity of body mass index as a definition of the obesity component of metabolic syndrome. Collegium Antropologicum 2007;31:943-7.

11. Amato1MC,GiordanoC,GaliaM,etal.Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010;33:920-2.

12. Schuster J, Vogel P, Eckhardt C, Morelo SDB. Applicability of the visceral adiposity index (VAI) in predicting components of metabolic syndrome in young adults. Nutricion Hospitalaria 2014;30:806-12.

13. Kahn HS. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population- based comparison. BMC Cardiovascular Disorders 2005;5:26.

14. Tellechea ML, Aranguren F, Martínez-Larrad MT, et al. Ability of lipid accumulation product to identify metabolic syndrome in healthy men from Buenos Aires. Diabetes Care

15. Guo S-x, Zhang X-h, Zhang J-y, et al. Visceral adiposity and anthropometric indicators as screening tools of metabolic syndrome among low income rural adults in Xinjiang. Scientific Reports 2016;6:36091.

16. Joshi H, Shah K, Patel P, et al. Novel indexes for diagnosing metabolic syndrome in apparently healthy Gujarati Asian Indians: a cross-sectional study. QJM: An International Journal of Medicine 2016;109:717-22.

17. Kavaric N, Klisic A, Ninic A. Are visceral adiposity index and lipid accumulation product reliable indices for metabolic disturbances in patients with type 2 diabetes mellitus? Journalof Clinical Laboratory Analysis 2018;32:e22283.

18. Borruel S, Moltó JF, Alpañés M, et al. Surrogate markers of visceral adiposity in young adults: waist circumference and body mass index are more accurate than waist hip ratio, model of adipose distribution and visceral adiposity index. PloS One 2014;9:e114112.

19. Consultation WE. Waist circumference and waist-hip ratio. Report of a WHO

Expert Consultation Geneva: World Health
Organization. 2008:8-11.

20. Thomas G. Pickering JEH, Lawrence J. et al Recommendations for blood pressure measurement in humans and experimental animals. AHA Scientific Statement. 2004.

21. Amato MC, Giordano C, Galia M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010;33:920-2.

22. WHO. Obesity and overweight Geneva: http:// www. WHO. Int/mediacentre/ factsheets / fs340/en; 2014.

23. Flynn J. The changing face of paediatric hypertension in the era of the childhood obesity epidemic. Paediatric Nephrology

24. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. The American Journal of Clinical Nutrition 2004;79:379-84.

25. Papathanasiou G, Zerva E, Zacharis I,et al.
Association of high blood pressure with body mass index, smoking and physical activity in healthy young adults. The Open Cardiovascular Medicine Journal 2015;9:5.

26. Suglia SF, Clark CJ, Gary-Webb TL.
Adolescent obesity, change in weight status, and hypertension: racial/ethnic variations. Hypertension 2013;61:290-5

27. Frey F. Body-mass-index, blood pressure, and serum cholesterol in young Swiss men: an analysis on 56784 army conscripts. Swiss Medical Weekly 2009;139(3536).

28. Kim J-a, Montagnani M, Koh KK, Quon MJ.
Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation 2006;113:1888-904.

29. Kalupahana NS, Massiera F, Quignard‐
Boulange A, et al. Overproduction of

angiotensinogen from adipose tissue induces adipose inflammation, glucose intolerance, and insulin resistance. Obesity 2012;20:48-56

30. da Silva AA, do Carmo JM, Hall JE. Role of leptin and CNS melanocortins in obesity hypertension. Current Opinion in Nephrology and Hypertension 2013;22:135

31. Yang F-Y, Wahlqvist ML, Lee M-S. Body mass index (BMI) as a major factor in the incidence of the metabolic syndrome and its constituents in unaffected Taiwanese from 1998 to 2002. Asia Pacific Journal of Clinical Nutrition

32. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA

33. Vazquez G, Duval S, Jacobs Jr DR, Silventoinen K. Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiologic Reviews 2007;29:115-28.

34. Kromhout D, Geleijnse JM, Boer JM, Verschuren WM. Body mass index and waist circumference predict both 10-year nonfatal and fatal cardiovascular disease risk: study conducted in 20 000 Dutch men and women aged 20–65 years. European Journal of Cardiovascular Prevention & Rehabilitation

35. Zazai R, Wilms B, Ernst B, Thurnheer M, Schultes B. Waist circumference and related anthropometric indices are associated with metabolic traits in severely obese subjects. Obesity Surgery 2014;24:777-82.

36 Bener A, Yousafzai MT, Darwish S, Al-Hamaq AO, Nasralla EA, Abdul-Ghani M. Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. Journal of Obesity 2013;2013.

37. Taylor SA, Hergenroeder AC. Waist circumference predicts increased cardiometabolic risk in normal weight adolescent males. International Journal of Paediatric Obesity 2011;6:e307-11.

38. Després J-P, Lemieux I, Bergeron J, et al.
Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arteriosclerosis, Thrombosis, and Vascular Biology 2008;28:1039-49.

39. Hou X, Lu J, Weng J, et al. Impact of waist circumference and body mass index on risk of cardiometabolic disorder and cardiovascular disease in Chinese adults: a national diabetes and metabolic disorders survey. PLoS One

40. Taverna MJ, Martínez-Larrad MT, Frechtel GD, Serrano-Ríos M. Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population. European Journal of Endocrinology 2011;164:559-67.