An optimized anthropometric index—a body shape index-cm—demonstrates superior performance in cardiovascular risk stratification

ObjectiveA body shape index is a novel indicator for assessing central obesity, but its relationship with cardiovascular disease and mortality remains unclear. This study aimed to assess whether a body shape index-cm, a refined version of a body shape index, improves cardiovascular risk stratification.MethodsUsing data from the National Health and Nutrition Examination Survey from 1999 to 2018, along with follow-up mortality data until 2019, we conducted an observational study to evaluate the performance of a body shape index-cm in identifying cardiovascular disease and predicting mortality. We compared a body shape index-cm with traditional anthropometric indices by employing receiver operating characteristic curve analysis, Cox proportional hazards regression, restricted cubic spline, and Kaplan-Meier survival analysis.ResultsAmong 47,668 participants, a body shape index-cm emerged as a superior screening tool for cardiovascular diseases, achieving an area under the curve of 0.701, surpassing those of waist-to-height ratio (0.631), waist circumference (0.624), and body mass index (0.556). A body shape index-cm showed the highest accuracy in identifying coronary heart disease (area under the curve: 0.728). A linear relationship was observed between a body shape index-cm and cardiovascular mortality risk, with each standard deviation increase in a body shape index-cm associated with a 20% increase in mortality risk.ConclusionsA body shape index-cm outperforms traditional measures in identifying cardiovascular disease and shows a linear correlation with cardiovascular mortality.