Fat-to-Bone Ratio May Be More Accurate Than BMI

Measuring an individual’s fat-to-bone ratio may provide a more accurate measure of obesity than body mass index (BMI), according to new research.

Because BMI does not consider the individual’s body type or fat distribution pattern, it may incorrectly suggest comorbidities, according to the researchers. For instance, individuals with an apple shape—fat distributed on their chest and abdomen—have a higher risk for heart disease and diabetes than individuals with a pear shape—fat distributed on the hips.
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To determine whether another measure could be more effective than BMI, the researchers reviewed 2703 upright posteroanterior chest radiography exams and calculated each individual’s BMI and fat-to-bone ratio, which involved dividing the soft-tissue thickness by the clavicle diameter.

They also noted the individuals’ age, sex, height, weight, and comorbidities associated with obesity, including atherosclerosis, coronary heart disease and hypertension.

After comparing the BMIs and fat-to-bone ratios, the researchers found that both measures were associated with hypertension, diabetes, hyperlipidemia, obstructive sleep apnea, and osteoarthritis.

However, fat-to-bone ratio was also associated with atherosclerosis, coronary artery disease, myocardial infarction, and peripheral vascular disease, whereas BMI was not.

“This study supports fat-to-bone ratio as an improved measurement of obesity,” the researchers concluded. “The ratio is more closely associated with most of the established comorbidities compared with BMI. Prospective research is warranted to confirm and establish category threshold values, similar to those of BMI. Other future considerations include the application of the fat-to-bone ratio concept to other anatomic locations, such as the abdomen and pelvis.”

—Amanda Balbi

Reference:

Roh A, Harned D, Patel A, et al. Fat-to-bone ratio: a new measurement of obesity. Presented at: American Roentgen Ray Society 2016 Annual Meeting; April 17-22, 2016: Los Angeles, CA. http://cf.arrs.org/abstracts/electronicexhibits/index.cfm?fid=E1215&app=false. Accessed April 26, 2016.