Association between A Body Shape Index (ABSI) and risk factors for non-communicable diseases in Iranian adults: a cross-sectional study findings from STEPS 2021

Non-communicable diseases (NCDs) are major global health problems. The A Body Shape Index (ABSI) has been proposed as an indicator of central obesity and cardio metabolic risk, but evidence on its association with multiple NCDs is still limited. The aim of this study is to examine the association between the Z-score of the A Body Shape Index (ABSI) and a comprehensive panel of non-communicable disease (NCDs) risk factors within the Iranian adult population. This cross-sectional study used data from the 2021 Iranian Stepwise Approach to NCD Risk Factor Surveillance (STEPS), based on systematic cluster random sampling. Assessed NCDs included dyslipidemia, hypertension, diabetes mellitus (DM), cardiovascular disease (CVD), and chronic kidney disease (CKD). The anthropometric parameter examined was ABSI Z-score. Data included physical measurements, laboratory results, and demographics. Statistical analyses comprised chi-square tests, ANOVA, and univariable and multivariable linear and logistic regressions. The study included 16,768 participants. Mean age of 47.7 ± 13.6 years. Of these, 9,634 (57.4%) were male and 7,152 (42.6%) were female. Each 1-SD increase in the ABSI Z-score was significantly associated with higher systolic blood pressure (SBP) (β = 1.11, 95% confidence interval [CI]: 0.77, 1.45), diastolic blood pressure (DBP) (β = 0.44; 0.22, 0.67), and fasting blood sugar (FBS) (β = 0.85; 0.20, 1.51), while an inverse association was observed with high-density lipoprotein cholesterol (HDL-C) (β = −0.34; −0.79, − 0.59). No significant associations were found with low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), glycated hemoglobin (HbA1c), or estimated glomerular filtration rate (eGFR). Higher ABSI Z Score significantly increased the risk for dyslipidemia (OR = 1.31; 1.15, 1.49), hypertension (OR = 1.26; 1.15, 1.40), DM (OR = 1.33; 1.12, 1.59), CVDs (OR = 1.27; 1.07, 1.51), and CKD (OR = 1.20; 1.04, 1.39). Each 1-SD increase in ABSI Z score was associated 16% higher risk for dyslipidemia (OR = 1.16; 1.08, 1.24) a 14% for hypertension (OR = 1.14; 1.09, 1.20), a 14% for DM (OR = 1.14; 1.04, 1.25), a 14 for CVDs (OR = 1.14; 1.09, 1.20), and 8% for CKD (OR = 1.08; 1.00, 1.16). The ABSI was significantly associated with several NCDs in this cross-sectional study, including hypertension, diabetes, cardiovascular disease, and chronic kidney disease among Iranian adults. Further studies are needed to confirm these findings and explore the potential role of ABSI in clinical practice.