Combining waist circumference and body mass index does not give a better prediction of health care costs than waist circumference alone
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Body mass index (BMI) is a surrogate measure of total body fat and not fat distribution, whereas waist circumference (WC) is a surrogate measure of abdominal fat mass. In the present study, the relationship between BMI and WC and future health costs (the latter as proxy for morbidity) was analyzed. The authors hypothesized that for all levels of BMI increased WC implied added future health care costs (Hypothesis 1) and for given levels of WC increased BMI entailed reduced future health care costs (Hypothesis 2), as fat mass and lean body mass may exert opposite effects on health. The analysis was based on data obtained from the Danish prospective cohort study Diet, Cancer and Health, including 15,334 men and 16,506 women 50 to 64 years old. Data analysis confirmed Hypothesis 1, suggesting that an increased level of abdominal fat for a given BMI results in higher health care costs. Hypothesis 2, reflecting that BMI had a protective effect for a given WC, was only confirmed in a subgroup of women (BMI<30 kg/m2 and WC<88 cm). Thus, WC for given levels of BMI predicts increased health costs, whereas BMI for given WC does not predict health costs except for lower health costs in non-obese women with normal WC. In conclusion, combining WC and BMI does not give a better cost prediction than WC alone.
Abstract
