ABSTRACT
Although health risks related to overweight and obesity have historically been defined by body mass index (BMI), increasing importance is being given to the central accumulation of fat in the abdominal cavity as a more specific, clinically actionable adiposity-biomarker to consider obesity-related cardiometabolic health risks. At any BMI level, an elevated waist circumference is predictive of an increased health hazard, making it an important vital sign to assess and follow in clinical practice. Within sub-groups of patients who are normal weight, overweight, or living with obesity, there is a linear increase in cardiovascular disease risk as a function of increased central adiposity with no clear cut-off value. Measuring only BMI or waist circumference alone, however, is not sufficient to optimally assess visceral adiposity, which is the primary marker of central fat accumulation associated with cardiovascular disease risk. There are several clinically applicable indicators of central adiposity that range from simple anthropometric indices to advanced body fat imaging analysis. Each biomarker has specific advantages and limitations pertaining to the assessment of central adiposity. Reduction in central adiposity in patients with visceral obesity is associated with considerable improvements in their cardiovascular disease risk profile, even in the absence of generalized body weight loss.
