Background:
Body mass index (BMI) is widely used in occupational health screening but does not account for fat distribution and may misclassify metabolic risk. Visceral fat area (VFA) may provide additional insight into cardiometabolic risk, particularly in physically active industrial populations. This study aimed to evaluate the comparative association of BMI and VFA with cardiometabolic abnormalities and to assess whether VFA improves risk stratification in an industrial workforce.
Methods: A cross-sectional study was conducted among 108 industrial workers undergoing occupational health surveillance. Body composition was assessed using bioelectrical impedance analysis. Cardiometabolic abnormality was defined as ≥1 of the following: elevated blood pressure, hypertriglyceridemia, low HDL cholesterol, dysglycemia, or corresponding medication use. BMI was categorized using Asian-Pacific cutoffs (≥23 kg/m²), and VFA as high (≥100 cm²). Associations were analyzed using chi-square tests and multivariable logistic regression adjusted for age and sex. Sensitivity analysis was performed within a ±30-day measurement interval.
Results: Among workers with BMI ≥23 kg/m², those with high VFA had a significantly higher prevalence of cardiometabolic abnormalities (82.5% vs. 48.9%, p<0.001). High VFA was independently associated with increased odds of abnormality (OR 6.66, 95% CI 2.30–19.31, p<0.001), whereas BMI was not independently associated. Results remained consistent in sensitivity analysis.
Conclusion: VFA improves cardiometabolic risk stratification beyond BMI and provides a more actionable basis for fitness-for-work assessment in industrial settings.
- 1. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories. Journal of the American Medical Association. 2013; 309 (1): 71-82. https://doi.org/10.1001/jama.2012.113905
- 2. Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Progress in Cardiovascular Diseases. 2014; 56 (4): 426-433. https://doi.org/10.1016/j.pcad.2013.10.003
- 3. Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J, et al. Accuracy of body mass index in diagnosing obesity in the adult general population. International Journal of Obesity. 2008; 32 (6): 959-966. https://doi.org/10.1038/ijo.2008.11
- 4. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007; 116 (1): 39-48. https://doi.org/10.1161/CIRCULATIONAHA.106.675355
- 5. Matsuzawa Y, Funahashi T, Nakamura T. The concept of metabolic syndrome: contribution of visceral fat accumulation and its molecular mechanism. Journal of Atherosclerosis and Thrombosis. 2011; 18 (8): 629-639. https://doi.org/10.5551/jat.7922
- 6. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an AHA/NHLBI scientific statement. Circulation. 2005; 112 (17): 2735-2752. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
- 7. Tatsumi Y, Nakao YM, Masuda I, et al. Risk for metabolic diseases in normal weight individuals with visceral fat accumulation: a cross-sectional study in Japan. British Medical Journal Open. 2017; 7 (1): e013831. https://doi.org/10.1136/bmjopen-2016-013831
- 8. Srikanthan P, Karlamangla AS. Relative muscle mass is inversely associated with insulin resistance and prediabetes. The Journal of Clinical Endocrinology & Metabolism. 2011; 96 (9): 2898-2903. https://doi.org/10.1210/jc.2011-0435
- 9. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004; 363 (9403): 157-163. https://doi.org/10.1016/S0140-6736(03)15268-3
- 10. Pan WH, Yeh WT. How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pacific Journal of Clinical Nutrition. 2008; 17 (3): 370-374. https://doi.org/10.6133/apjcn.2008.17.3.02
- 11. Kyle UG, Bosaeus I, De Lorenzo A, Deurenberg P, Elia M, Gómez JM, et al. Bioelectrical impedance analysis—part I: review of principles and methods. Clinical Nutrition. 2004; 23 (5): 1226-1243. https://doi.org/10.1016/j.clnu.2004.06.004
- 12. Bosy-Westphal A, Later W, Hitze B, Sato T, Kossel E, Glüer CC, et al. Accuracy of bioelectrical impedance consumer devices for measurement of body composition in comparison to whole body magnetic resonance imaging and dual X-ray absorptiometry. Obesity Facts. 2008; 1 (6): 319-324. https://doi.org/10.1159/000176061
- 13. Lee JK, Park YS, Kim K, Oh TJ, Chang W. Comparison of bioelectrical impedance analysis and computed tomography on body composition changes including visceral fat after bariatric surgery in Asian patients with obesity. Obesity Surgery. 2021; 31 (10): 4243-4250. https://doi.org/10.1007/s11695-021-05569-6
- 14. Ryo M, Kishida K, Nakamura T, Yoshizumi T, Funahashi T, Shimomura I. Clinical significance of visceral adiposity assessed by a new method of bioelectrical impedance analysis. Diabetes Care. 2005; 28 (2): 451-453. https://doi.org/10.2337/diacare.28.2.451
- 15. Examination Committee of Criteria for 'Obesity Disease' in Japan. New criteria for 'obesity disease' in Japan. Circulation Journal. 2002; 66 (11): 987-992. https://doi.org/10.1253/circj.66.987
- 16. Alberti KGM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the IDF Task Force on Epidemiology and Prevention; NHLBI; AHA; WHF; IAC; and IAS. Circulation. 2009; 120 (16): 1640-1645. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
- 17. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults. Circulation. 2014; 129 (25_suppl_2): S102-S138. https://doi.org/10.1161/01.cir.0000437739.71477.ee
- 18. Sung HH, Park CE, Gi MY, Cha JA, Moon AE, Kang JK, et al. The association of the visceral adiposity index with insulin resistance and beta-cell function in Korean adults with and without type 2 diabetes mellitus. Endocrine Journal. 2020; 67 (5): 515-525. https://doi.org/10.1507/endocrj.ej19-0517
- 19. Piché ME, Tchernof A, Després JP. Obesity phenotypes, diabetes, and cardiovascular diseases. Circulation Research. 2020; 126 (11): 1477-1500. https://doi.org/10.1161/circresaha.120.316101
- 20. Ross R, Neeland IJ, Yamashita S, Shai I, Seidell J, Magni P, et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nature Reviews Endocrinology. 2020; 16 (3): 177-189. https://doi.org/10.1038/s41574-019-0310-7
- 21. Goossens GH. The metabolic phenotype in obesity: fat mass, body fat distribution, and adipose tissue function. Obesity Facts. 2017; 10 (3): 207-215. https://doi.org/10.1159/000471488
- 22. Snijder MB, van Dam RM, Visser M, Seidell JC. What aspects of body fat are particularly hazardous and how do we measure them? International Journal of Epidemiology. 2006; 35 (1): 83-92. https://doi.org/10.1093/ije/dyi253
- 23. Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update. Physiological Reviews. 2013; 93 (1): 359-404. https://doi.org/10.1152/physrev.00033.2011
- 24. Neeland IJ, Ross R, Després JP, Matsuzawa Y, Yamashita S, Shai I, et al. Visceral and ectopic fat, atherosclerosis, and cardiovascular disease: a position statement. The Lancet Diabetes & Endocrinology. 2019; 7 (9): 715-725. https://doi.org/10.1016/s2213-8587(19)30084-1
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