Beyond BMI: association of body roundness, abdominal volume, conicity and body shape indices with insulin resistance and metabolic risk in urban Indian adolescents and adults

Authors

  • Sharvari R. Desai Kasturba Integrative Health Sciences- Medical Research Foundation, Mumbai, India
  • Apurva Halbe Kasturba Integrative Health Sciences- Medical Research Foundation, Mumbai, India
  • Panchali Moitra Department of Food, Nutrition and Dietetics, Sir Vithaldas Thackersey College of Home Science (Empowered Autonomous Status), SNDT Women's University, Juhu Tara Road, Santacruz West, Mumbai, Maharashtra, India
  • Sheryl Salis Nurture Health Solutions, Mumbai, Maharashtra, India
  • Jagmeet Madan Department of Food, Nutrition and Dietetics, Sir Vithaldas Thackersey College of Home Science (Empowered Autonomous Status), SNDT Women's University, Juhu Tara Road, Santacruz West, Mumbai, Maharashtra, India
  • Shobha A. Udipi Kasturba Integrative Health Sciences- Medical Research Foundation, Mumbai, India
  • Rama A. Vaidya Kasturba Integrative Health Sciences- Medical Research Foundation, Mumbai, India
  • Soumik Kalita FamPhy, Bengaluru, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20263611

Keywords:

Body roundness index, Insulin resistance, Urban Indian adults, Abdominal volume index, A body shape index, Conicity index

Abstract

Background: Body roundness index (BRI), Abdominal volume index (AVI), Conicity index (CI), and a body shape index (ABSI) have been proposed as improved predictors of adiposity and metabolic risk. This study evaluated gender differences, age-related trends, diagnostic performance and associations of these indices with adiposity and metabolic parameters.

Methods: A cross-sectional analysis was conducted among 1,998 apparently healthy Indian adolescents and adults (620 males and 1,378 females;16–55 years) from the Mumbai Metropolitan Region. Anthropometric measurements, body composition, and biochemical parameters were assessed. BRI, AVI, CI, and ABSI were calculated. Gender differences were compared using independent t-tests, age-related trends across quintiles, receiver operating characteristic analysis assessed diagnostic accuracy, and Pearson's correlation examined associations with metabolic parameters.

Results: Adiposity indices increased significantly with age, whereas muscle mass declined (p<0.001). Females had higher BMI, waist-to-height ratio, body fat percentage, and BRI, while males had higher waist circumference, waist-to-hip ratio, visceral fat, muscle mass, AVI, CI, and ABSI (all p<0.01). BRI showed the highest accuracy for identifying obesity (AUC=0.953) and central obesity (AUC=1.000), followed by AVI. Both BRI and AVI correlated with adiposity measures, fasting glucose, fasting insulin, HbA1c, and HOMA-IR (all p<0.001). AVI was independently associated with HOMA-IR and fasting insulin, whereas BRI was associated with the fasting glucose-to-insulin ratio.

Conclusion: BRI and AVI are reliable, low-cost markers of adiposity and early metabolic dysfunction. BRI showed superior diagnostic accuracy for obesity, whereas AVI demonstrated stronger associations with insulin resistance, supporting their use in early cardiometabolic risk screening among apparently healthy Indian populations.

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References

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027-50.

Yang M, Liu S, Zhang C. The related metabolic diseases and treatments of obesity. Healthcare (Basel). 2022;10(9):1616. DOI: https://doi.org/10.3390/healthcare10091616

Lin X, Li H. Obesity: epidemiology, pathophysiology, and therapeutics. Front Endocrinol (Lausanne). 2021;12:706978. DOI: https://doi.org/10.3389/fendo.2021.706978

Swarup S, Ahmed I, Grigorova Y, Zeltser R. Metabolic syndrome. [Updated 2024 Mar 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 [cited 2026 Sep 23]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459248/. Accessed on 17 May 2026.

Bhalwar R. Metabolic syndrome: the Indian public health perspective. Med J Armed Forces India. 2020;76(1):8-16. DOI: https://doi.org/10.1016/j.mjafi.2019.12.001

Basu S, Thirunavukarasu AJ, Maheshwari V, Zode M, Hassan R. Burden, determinants and treatment status of metabolic syndrome among older adults in India: a nationally representative, community-based cross-sectional survey. BMJ Public Health. 2023;1(1):e000389. DOI: https://doi.org/10.1136/bmjph-2023-000389

Després JP, Lemieux I, Bergeron J, Pibarot P, Mathieu P, Larose E, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol. 2008;28(6):1039-49. DOI: https://doi.org/10.1161/ATVBAHA.107.159228

Paley CA, Johnson MI. Abdominal obesity and metabolic syndrome: exercise as medicine? BMC Sports Sci Med Rehabil. 2018;10:7. DOI: https://doi.org/10.1186/s13102-018-0097-1

Islam MS, Wei P, Suzauddula M, Nime I, Feroz F, Acharjee M, et al. The interplay of factors in metabolic syndrome: understanding its roots and complexity. Mol Med. 2024;30(1):279. DOI: https://doi.org/10.1186/s10020-024-01019-y

Ritchie SA, Connell JM. The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutr Metab Cardiovasc Dis. 2007;17(4):319-26. DOI: https://doi.org/10.1016/j.numecd.2006.07.005

D'Oria R, Genchi VA, Caccioppoli C, Calderoni I, Marrano N, Biondi G, et al. Impact of dysfunctional adipose tissue depots on the cardiovascular system. Int J Mol Sci. 2022;23(22):14296. DOI: https://doi.org/10.3390/ijms232214296

An SM, Cho SH, Yoon JC. Adipose tissue and metabolic health. Diabetes Metab J. 2023;47(5):595-611. DOI: https://doi.org/10.4093/dmj.2023.0011

Chait A, den Hartigh LJ. Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Front Cardiovasc Med. 2020;7:22. DOI: https://doi.org/10.3389/fcvm.2020.00022

Lee SW, Son JY, Kim JM, Hwang SS, Han JS, Heo NJ. Body fat distribution is more predictive of all-cause mortality than overall adiposity. Diabetes Obes Metab. 2018;20(1):141-7. DOI: https://doi.org/10.1111/dom.13050

Chang Y, Guo X, Li T, Li S, Guo J, Sun Y. A body shape index and body roundness index: two new body indices to identify left ventricular hypertrophy among rural populations in northeast China. Heart Lung Circ. 2016;25(4):358-64. DOI: https://doi.org/10.1016/j.hlc.2015.08.009

Zhang N, Chang Y, Guo X, Chen Y, Ye N, Sun Y. A body shape index and body roundness index: two new body indices for detecting association between obesity and hyperuricemia in rural area of China. Eur J Intern Med. 2016;29:32-6. DOI: https://doi.org/10.1016/j.ejim.2016.01.019

Maessen MF, Eijsvogels TM, Verheggen RJ, Hopman MT, Verbeek AL, de Vegt F. Entering a new era of body indices: the feasibility of a body shape index and body roundness index to identify cardiovascular health status. PLoS One. 2014;9(9):e107212. DOI: https://doi.org/10.1371/journal.pone.0107212

Chang Y, Guo X, Chen Y, Guo L, Li Z, Yu S, et al. A body shape index and body roundness index: two new body indices to identify diabetes mellitus among rural populations in northeast China. BMC Public Health. 2015;15:794. DOI: https://doi.org/10.1186/s12889-015-2150-2

Liu Y, Liu X, Guan H, Zhang S, Zhu Q, Fu X, et al. Body roundness index is a superior obesity index in predicting diabetes risk among hypertensive patients: a prospective cohort study in China. Front Cardiovasc Med. 2021;8:736073. DOI: https://doi.org/10.3389/fcvm.2021.736073

Pitanga FJG, Lessa I. Sensitivity and specificity of the conicity index as a coronary risk predictor among adults in Salvador, Brazil. Rev Bras Epidemiol. 2004;7(3):259-69. DOI: https://doi.org/10.1590/S1415-790X2004000300004

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63. DOI: https://doi.org/10.1016/S0140-6736(03)15268-3

Ashwell M, Gibson S. Waist-to-height ratio as an indicator of 'early health risk': simpler and more predictive than using a 'matrix' based on BMI and waist circumference. BMJ Open. 2016;6(3):e010159. DOI: https://doi.org/10.1136/bmjopen-2015-010159

Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen W, Gallagher D, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring). 2013;21(11):2264-71. DOI: https://doi.org/10.1002/oby.20408

Christakoudi S, Tsilidis KK, Muller DC, Freisling H, Weiderpass E, Overvad K, et al. A body shape index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort. Sci Rep. 2020;10(1):14541. DOI: https://doi.org/10.1038/s41598-020-71302-5

Ryu K, Suliman ME, Qureshi AR, Chen Z, Avesani CM, Brismar TB, et al. Central obesity as assessed by conicity index and a-body shape index associates with cardiovascular risk factors and mortality in kidney failure patients. Front Nutr. 2023;10:1035343. DOI: https://doi.org/10.3389/fnut.2023.1035343

Guerrero-Romero F, Rodríguez-Morán M. Abdominal volume index. An anthropometry-based index for estimation of obesity is strongly related to impaired glucose tolerance and type 2 diabetes mellitus. Arch Med Res. 2003;34(5):428-32. DOI: https://doi.org/10.1016/S0188-4409(03)00073-0

Unnikrishnan R, Anjana RM, Mohan V. Diabetes in South Asians: is the phenotype different? Diabetes. 2014;63(1):53-5. DOI: https://doi.org/10.2337/db13-1592

Vlassopoulos A, Combet E, Lean MEJ. Changing distributions of body size and adiposity with age. Int J Obes (Lond). 2014;38(6):857-64. DOI: https://doi.org/10.1038/ijo.2013.216

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Published

2026-09-30

How to Cite

Desai, S. R., Halbe, A., Moitra, P., Salis, S., Madan, J., A. Udipi, S., Vaidya, R. A., & Kalita, S. (2026). Beyond BMI: association of body roundness, abdominal volume, conicity and body shape indices with insulin resistance and metabolic risk in urban Indian adolescents and adults. International Journal Of Community Medicine And Public Health, 13(10), 5797–5805. https://doi.org/10.18203/2394-6040.ijcmph20263611

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Original Research Articles