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
Copyright (c) 2026 INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright Rights & Permissions Guide
Reproducing Published Material from other Publishers
It is absolutely essential that authors obtain permission to reproduce any published material (figures, schemes, tables or any extract of a text) which does not fall into the public domain, or for which they do not hold the copyright. Permission should be requested by the authors from the copyright holder (usually the Publisher, please refer to the imprint of the individual publications to identify the copyright holder).
Permission is required for:
- Your own works published by other Publishers and for which you did not retain copyright.
- Substantial extracts from anyones’ works or a series of works.
- Use of Tables, Graphs, Charts, Schemes and Artworks if they are unaltered or slightly modified.
- Photographs for which you do not hold copyright.
Permission is not required for:
- Reconstruction of your own table with data already published elsewhere. Please notice that in this case you must cite the source of the data in the form of either “Data from…” or “Adapted from…”.
- Reasonably short quotes are considered fair use and therefore do not require permission.
- Graphs, Charts, Schemes and Artworks that are completely redrawn by the authors and significantly changed beyond recognition do not require permission.
Obtaining Permission
In order to avoid unnecessary delays in the publication process, you should start obtaining permissions as early as possible. If in any doubt about the copyright, apply for permission. JNH cannot publish material from other publications without permission.
The copyright holder may give you instructions on the form of acknowledgement to be followed; otherwise follow the style: “Reproduced with permission from [author], [book/journal title]; published by [publisher], [year].’ at the end of the caption of the Table, Figure or Scheme.
Every mansucript should be accompanied by "Copyright Transfer Agreement" prior to the article publication
Similar Articles
- Musfirah Fhyra, Syamsu Andi Kamaruddin, Arli Adam, Andi Ihsan, Hasma, Traditional Health Practices In The Kajang Community: Health Practices , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 6 No. 1 (2024): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Mukhlis, Syahrial, Frima Elda, Denas Symond, Deni Elnovriza, Eva Yuniritha, ANALYSIS OF PHYSICAL ACTIVITY AND NITRIC OXIDE ON THE INCIDENCE OF HYPERTENSION AMONG THE ELDERLY IN THE WORKING AREA OF NANGGALO PUBLIC HEALTH CENTER IN 2025 : HYPERTENSION AMONG THE ELDERLY , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 7 No. 2 (2025): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Asmawati Asmawati, Tasnim Tasnim, Sunarsih Sunarsih, THE RELATIONSHIP BETWEEN COMPETENCY AND SERVICE OFFICERS ON THE ACHIEVEMENT OF EXCLUSIVE BREASTFEEDING TARGETS IN KENDARI CITY HEALTH DEPARTMENT: EXCLUSIVE BREASTFEEDING TARGETS , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 3 No. 1 (2021): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Ridhayani Djabar, Tasnim Tasnim, Sanihu Munir, THE RELATIONSHIP OF ELDERLY BEHAVIOR WITH VISIT COMPLIANCE AT THE ELDERLY POSYANDU REVIEW FROM THE HEALTH BELIEF THEORY IN THE POMALAA PUSKESMAS AREA: Elderly behavior , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 3 No. 2 (2021): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Daslan Daslan, La Ode Saafi, Tasnim Tasnim, THE RELATIONSHIP BETWEEN HUMAN RESOURCES AND PLANNING WITH MINIMUM COVERAGE OF HEALTH CARE SERVICES IN KONAWE REGENCY: HUMAN RESOURCES AND PLANNING , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 3 No. 2 (2021): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Noviati Noviati, Toto Surianto S, La Djabo Buton, Ahmad Mudatsir, The Relationship between Perception and Community Willingness in COVID-19 Vaccination in the Working Area in the Nambo Health Center, Kendari City: Perception and COVID-19 Vaccination , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 4 No. 2 (2022): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Asri Dewi, Timbul Supodo, Kartini Kartini, THE RELATIONSHIP BETWEEN SUPPORT OF HUSBAND AND HEALTH OFFICERS AND HIV TESTING IN PREGNANT MOTHERS IN KENDARI CITY HEALTH CENTRE: HIV TESTING IN PREGNANT MOTHERS , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 3 No. 2 (2021): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Hasniah Dina, Dedi Krismiadi, Apriyanti, The Factors of Failure to Exclusively Breastfeed In the BLUD UPTD Working Area of the Kandai Public Health Center of Kendari City: Exclusively Breastfeed , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 6 No. 1 (2024): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Tasnim Tasnim, Ade Saputra, THE EFFECT OF HEALTH PROMOTION USING BOOKLET MEDIA ON THE LEVEL OF PUBLIC KNOWLEDGE ABOUT SEWERAGE WASTE WATER IN COASTAL AREAS SAMAJAYA VILLAGE: HEALTH PROMOTION USING BOOKLET MEDIA , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 4 No. 1 (2022): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
- Noviati Noviati, Muhammad Ramdan, Abdul Rahim Sya`ban, Juslan, The Mobilization Of Metal Elements Against The Incidence Of Dermatitis Is Seen From Community Knowledge In The Mining Circle In Amonggedo Sub-District, Konawe District : Dermatitis Is Seen From Community Knowledge , INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD): Vol. 6 No. 1 (2024): INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT
You may also start an advanced similarity search for this article.





