Novel adiposity indices and their role in identifying left ventricular hypertrophy among hypertensive individuals undergoing echocardiography

Abstract

Background and aims

While body mass index (BMI) is the most used measure of adiposity, it does not account for fat distribution. Novel indices, such as A Body Shape Index (ABSI) and Body Roundness Index (BRI), may better reflect cardiometabolic risk. However, their association with subclinical cardiac damage, particularly left ventricular hypertrophy (LVH), remains unclear. The aim of this study was to evaluate the association between novel adiposity indices (ABSI and BRI) and left ventricular mass (LVM) assessed by echocardiography in a large cohort of patients with hypertensive.

Methods and results

We conducted a cross-sectional study including 724 hypertensive adults who underwent standardized anthropometric and echocardiographic assessments. Adiposity indices (BMI, waist circumference, ABSI, and BRI) were calculated, and left ventricular mass was indexed to body surface area and height^2.7. Correlations and multivariate analyses were performed, and receiver operating characteristic (ROC) curves were used to assess diagnostic performance. All adiposity indices were significantly higher in individuals with LVH. BRI showed the strongest correlation with LVMH^2.7 (r = 0.423), particularly in women. In multivariate analysis, BRI remained significantly associated with LVMH^2.7 in both sexes, while ABSI was not independently associated in men. ROC curve analysis demonstrated that BRI had the highest diagnostic accuracy for identifying LVH, outperforming BMI and ABSI, especially when LVH was defined using LVMH^2.7.

Conclusions

BRI outperformed traditional and novel adiposity indices in identifying LVH in hypertensive patients, particularly when LVM was indexed to height^2.7. Given its superior diagnostic performance, BRI may represent a valuable tool in cardiovascular risk stratification, though further studies are warranted.